Mattie Ann Haas, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

051.297378 Issued in IL

Practice address

1350 Mulholland St
Nauvoo, IL 62354-1010

Phone

(217) 453-2717

Fax

(217) 453-6456

NPI assigned

Feb 8, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Nauvoo Pharmacy, PLLC

  • Community/Retail Pharmacy
  • Nauvoo, IL
  • NPI 1205078847
  NPD Authorized official
• Nauvoo Pharmacy, PLLC

  • Community/Retail Pharmacy
  • Nauvoo, IL
  • NPI 1740914654
  NPD Authorized official

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

{
    "created_epoch": "1423353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1235520644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 248",
            "city": "NAUVOO",
            "state": "IL",
            "postal_code": "623540248",
            "telephone_number": "217-453-2717",
            "fax_number": "217-453-6456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 MULHOLLAND ST",
            "city": "NAUVOO",
            "state": "IL",
            "postal_code": "623541010",
            "telephone_number": "217-453-2717",
            "fax_number": "217-453-6456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAS",
        "first_name": "MATTIE",
        "middle_name": "ANN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-08",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "21966",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.297378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deanne A Brooks, SSP
• Lauren Carlisle
• Carol Ann Conrad III, EDD
• Thomas Earl Grant Jr., D.C.
• Luann Haas
• Julie Herbstrith, PH.D.
• Ruth Kelly, PHD
• Memorial Hospital Association
• Gregory A Miller, MD
• David E. Morgan, D.C.

• Pharmacist in Nauvoo, IL
• Providers in Nauvoo, IL by specialty
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; 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.