Individual provider Active NPI

Karen Haveman, MSN, CPNP

  • Pediatric Nurse Practitioner
  • Lackland a F B, TX
National Provider Identifier
1144328055
Registry record updated Jun 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
512848 Issued in TX
Practice address
2200 Bergquist Dr Ste 1
Attn: OB/GYN Clnic/ Sgobg
Lackland a F B, TX 78236-9908
Phone
(210) 292-6452
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 512848 TX Primary

Addresses

Primary practice location

2200 Bergquist Dr Ste 1
Attn: OB/GYN Clnic/ Sgobg
Lackland a F B, TX 78236-9908

Mailing address

680 Five Oaks Cir
Canyon Lake, TX 78133-5148
Phone (210) 237-9903

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)
Not enrolled
Credentials
Certified Pediatric Nurse Practitioner, Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
512848TXMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371427200000",
    "number": "1144328055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 FIVE OAKS CIR",
            "city": "CANYON LAKE",
            "state": "TX",
            "postal_code": "781335148",
            "telephone_number": "210-237-9903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR STE 1",
            "address_2": "ATTN: OB/GYN CLNIC/ SGOBG",
            "city": "LACKLAND A F B",
            "state": "TX",
            "postal_code": "782369908",
            "telephone_number": "210-292-6452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVEMAN",
        "first_name": "KAREN",
        "credential": "MSN, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2013-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "512848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lackland a F B, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; 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.