Active NPI
Walter Darrel Haggard, D.C.
- Chiropractor
- Glendale, AZ
National Provider Identifier
1174645279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 813
- Practice address
- 18205 N 51St Ave
Suite 147
Glendale, AZ 85308-1490 - Phone
- (602) 997-7531
- Fax
- (602) 997-7797
- NPI assigned
- Apr 6, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 813 | AZ | Primary |
Addresses
Primary practice location
18205 N 51St Ave
Suite 147
Glendale, AZ 85308-1490
Mailing address
18205 N 51St Ave
Suite 147
Glendale, AZ 85308-1490
Phone (602) 997-7531
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051108000717 | AZ | Practitioner - Chiropractic | 1153349121 | Practice locations: Glendale, AZ |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 813 | AZ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| JDH Chiropractic Inc | Chiropractor | Past | Accepting new patients |
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.
-
- Chiropractor
- Glendale, AZ
- NPI 1609916097
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247616000000",
"number": "1174645279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18205 N 51ST AVE",
"address_2": "SUITE 147",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853081490",
"telephone_number": "602-997-7531",
"fax_number": "602-997-7797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18205 N 51ST AVE",
"address_2": "SUITE 147",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853081490",
"telephone_number": "602-997-7531",
"fax_number": "602-997-7797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAGGARD",
"first_name": "WALTER",
"middle_name": "DARREL",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-06",
"last_updated": "2009-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AZ",
"license": "813",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.