Ernest E. Haecker, M.S.,CCC-A, ABA
Individual provider Active NPI Audiologist · Raton, NM
NPI 1083784425 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1083784425
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Audiologist 231H00000X
- License
- 216 (NM)
- Practice address
- 101 N 2ND St
Raton, NM 87740-3803 - Phone
- (505) 445-7090
- NPI assigned
- Nov 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Associate of Business Administration, Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| High Plains Regional Educational Coop | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 216 | NM | Yes |
Addresses
Primary practice location
101 N 2ND St
Raton, NM 87740-3803
Mailing address
PO Box 187
Wagon Mound, NM 87752-0187
Phone (505) 820-7657
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 54858 | Medicaid | NM |
Other providers in Raton, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.