Carol Therese Haughey, PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

311023 Issued in WI

Practice address

1050 Legion Drive
Elm Grove, WI 53122

Phone

(262) 782-8272

Fax

(262) 782-5420

NPI assigned

Nov 2, 2006

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

• Carol Hess Haughey Professional name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043398464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 LEGION DRIVE",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "53122",
            "telephone_number": "262-782-8272",
            "fax_number": "262-782-5420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 LEGION DRIVE",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "53122",
            "telephone_number": "262-782-8272",
            "fax_number": "262-782-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUGHEY",
        "first_name": "CAROL",
        "middle_name": "THERESE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "311023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30477700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "HESS HAUGHEY",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Gary D Heath, LCSW, LMFT
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• All providers in Elm Grove, WI
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.