Individual provider Active NPI

Christopher M Haniford

  • Physician Assistant
  • Colorado Springs, CO
National Provider Identifier
1144773524
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0005780 Issued in CO
Practice address
1400 E Boulder St
Colorado Springs, CO 80909-5533
Phone
(719) 365-6820
Fax
(719) 365-6595
NPI assigned
Aug 2, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 3715 CT
Physician Assistant 363A00000X PA.0005780 CO Primary

Addresses

Primary practice location

1400 E Boulder St
Colorado Springs, CO 80909-5533

Mailing address

71 Porters Pass
Apt #1
Berlin, CT 06037-1415
Phone (727) 543-1043

Other practice location 1

41 Brewster Rd
Bristol, CT 06010-5161
Phone (860) 585-3333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211020002346 CO Practitioner - Physician Assistant 2264711795 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthone Clinic Services Orthopedic Specialists LLCGroup PAC ID 5799972725, 81 clinicians

Practice addresses (Care Compare)

4105 Briargate Pkwy
Suite 300
Colorado Springs, CO 80920-3487
Phone (719) 402-0200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.0005780COMDPhysician Assistant

Organizations & group practices 2

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": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1144773524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 PORTERS PASS",
            "address_2": "APT #1",
            "city": "BERLIN",
            "state": "CT",
            "postal_code": "060371415",
            "telephone_number": "727-543-1043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E BOULDER ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095533",
            "telephone_number": "719-365-6820",
            "fax_number": "719-365-6595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Brewster Rd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "CT",
            "postal_code": "060105161",
            "country_code": "US",
            "telephone_number": "860-585-3333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANIFORD",
        "first_name": "CHRISTOPHER",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-02",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "3715",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0005780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.