Individual provider Active NPI

Edward W Haughn, DO

  • Family Medicine Physician
  • Kalamazoo, MI
National Provider Identifier
1093819732
Registry record updated Dec 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101010075 Issued in MI
Practice address
117 W Paterson St
Kalamazoo, MI 49007-2557
Phone
(269) 349-2641
NPI assigned
Sep 12, 2006
Last updated
Dec 27, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101010075 MI Primary

Addresses

Primary practice location

117 W Paterson St
Kalamazoo, MI 49007-2557

Mailing address

117 W Paterson St
Kalamazoo, MI 49007-2557
Phone (269) 349-2641

Other practice location 1

505 E Alcott St
Kalamazoo, MI 49001-6144
Phone (269) 349-2641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051010000243 MI Practitioner - Family Practice 4486679495 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Center Inc CurrentSince Feb 13, 2014 Accepting new patients
Family Health Center Inc. Family Medicine CurrentSince Feb 13, 2014 Accepting new patients
Family Health Center Inc Current Accepting new patients
Western Michigan University School of Medicine Past Accepting new patients
Michigan State University Kalamazoo Center for Medical Studies Past Accepting new patients

Locations

117 W Paterson St
Kalamazoo, MI 49007

505 E Alcott St
Kalamazoo, MI 49001
Phone 2693492641 ext. 715

325 E Centre Ave
Portage, MI 49002
Phone 2693492641 ext. 231

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1093819732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W PATERSON ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490072557",
            "telephone_number": "269-349-2641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W PATERSON ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490072557",
            "telephone_number": "269-349-2641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 E Alcott St",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490016144",
            "country_code": "US",
            "telephone_number": "269-349-2641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAUGHN",
        "first_name": "EDWARD",
        "middle_name": "W",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101010075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.