Active NPI
Gregory A Hauge, PHD
- Psychologist
- Fargo, ND
National Provider Identifier
1063443729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 208
- Practice address
- 1702 University Dr S
Fargo, ND 58103-4940 - Phone
- (701) 364-3300
- Fax
- (701) 364-8906
- NPI assigned
- Jul 5, 2006
- Last updated
- Jul 17, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 208 | ND | Primary |
| Psychologist | 103T00000X | LP4440 | MN |
Addresses
Primary practice location
1702 University Dr S
Fargo, ND 58103-4940
Mailing address
PO Box 6001
Fargo, ND 58108-6001
Phone (701) 364-3300
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36594HA | Other | ND | MNBS # |
| 137095 | Other | ND | UCARE # |
| DA9011026969 | Other | ND | PREFERRED ONE # |
| 676706 | Other | ND | AMERICA'S PPO/ARAZ # |
| ND200086 | Other | ND | LHS # |
| HP25773 | Other | ND | HEALTHPARTNERS # |
| 16920 | Medicaid | ND | |
| 5342 | Other | ND | NDBS # |
| 6134949 | Other | ND | MEDICA # |
| 23120 | Other | ND | ND MEDICARE# |
| 268750000 | Medicaid | ND | |
| 370J8HA | Other | ND | MNBS # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP4440 | MN | MD | Psychologist |
| 208 | ND | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342483200000",
"number": "1063443729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6001",
"city": "FARGO",
"state": "ND",
"postal_code": "581086001",
"telephone_number": "701-364-3300",
"fax_number": "701-364-8906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1702 UNIVERSITY DR S",
"city": "FARGO",
"state": "ND",
"postal_code": "581034940",
"telephone_number": "701-364-3300",
"fax_number": "701-364-8906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAUGE",
"first_name": "GREGORY",
"middle_name": "A",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-05",
"last_updated": "2012-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "ND",
"license": "208",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP4440",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MNBS #",
"identifier": "36594HA",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE #",
"identifier": "137095",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE #",
"identifier": "DA9011026969",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICA'S PPO/ARAZ #",
"identifier": "676706",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LHS #",
"identifier": "ND200086",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS #",
"identifier": "HP25773",
"state": "ND"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "16920",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NDBS #",
"identifier": "5342",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA #",
"identifier": "6134949",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ND MEDICARE#",
"identifier": "23120",
"state": "ND"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "268750000",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MNBS #",
"identifier": "370J8HA",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.