Individual provider Active NPI

Kevin Timothy Haag, DPM

  • Foot & Ankle Surgery Podiatrist
  • Ooltewah, TN
National Provider Identifier
1174044010
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
877 Issued in TN
Practice address
4957 Swinyar Dr Ste 105
Ooltewah, TN 37363-2205
Phone
(423) 396-3668
Fax
(423) 396-2436
NPI assigned
Jun 30, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 877 TN Primary
Podiatrist 213E00000X 877 TN

Addresses

Primary practice location

4957 Swinyar Dr Ste 105
Ooltewah, TN 37363-2205

Mailing address

4957 Swinyar Dr Ste 105
Ooltewah, TN 37363-2205
Phone (423) 396-3668

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200727000160 TN Practitioner - Podiatry 1951670843 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Haag Foot and Ankle PLLCGroup PAC ID 9638489776, 2 clinicians

Practice addresses (Care Compare)

4957 Swinyar Dr
Suite 105
Ooltewah, TN 37363-2205
Phone (423) 396-3668

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue126
Removal of skin lesions1-10
Removal of nail tissue374

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5901002704MIMDPodiatrist
877TNMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Haag Foot and Ankle PLLC Podiatrist CurrentSince Jul 13, 2020 Accepting new patients

Locations

9325 Apison Pike
Ste 137
Ooltewah, TN 37363
Phone (423) 396-3668

4957 Swinyar Dr
Ste 105
Ooltewah, TN 37363
Phone (423) 396-3668

Organizations & group practices 1

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1498780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1174044010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4957 SWINYAR DR STE 105",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373632205",
            "telephone_number": "423-396-3668",
            "fax_number": "423-396-2436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4957 SWINYAR DR STE 105",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373632205",
            "telephone_number": "423-396-3668",
            "fax_number": "423-396-2436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAG",
        "first_name": "KEVIN",
        "middle_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-30",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TN",
            "license": "877",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TN",
            "license": "877",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ooltewah, TN

Sources for this page

Verify at the official NPI Registry.