Individual provider Active NPI

Stephen Arthur Habener, M.D., INC., P.S.

  • Specialist
  • Bremerton, WA
National Provider Identifier
1073539573
Registry record updated Jan 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD00011993 Issued in WA
Practice address
2635 Wheaton Way
Bremerton, WA 98310-3318
Phone
(360) 373-2571
Fax
(360) 479-4970
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD00011993 WA Primary

Addresses

Primary practice location

2635 Wheaton Way
Bremerton, WA 98310-3318

Mailing address

2635 Wheaton Way
Bremerton, WA 98310-3318
Phone (360) 373-2571

Other identifiers 1

IdentifierTypeStateIssuer
1340306MedicaidWA

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 Medicine

State licenses

LicenseStateTypeSpecialty
MD00011993WAMDSpecialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327449600000",
    "number": "1073539573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2635 WHEATON WAY",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983103318",
            "telephone_number": "360-373-2571",
            "fax_number": "360-479-4970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 WHEATON WAY",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983103318",
            "telephone_number": "360-373-2571",
            "fax_number": "360-479-4970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABENER",
        "first_name": "STEPHEN",
        "middle_name": "ARTHUR",
        "name_prefix": "Dr.",
        "credential": "M.D., INC., P.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2012-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MD00011993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1340306",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.

Verify at the official NPI Registry.