NPIMap

Individual provider Active NPI

Kenneth R Hauswald, M.D.

  • Surgery Physician
  • Cary, NC
National Provider Identifier
1245236124
Registry record updated Mar 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
17366 Issued in NC
Practice address
1505 SW Cary Pkwy
Suite 302
Cary, NC 27511-6219
Phone
(919) 367-2580
NPI assigned
Jun 24, 2005
Reactivated
Mar 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 17366 NC Primary
Surgery Physician 208600000X 16406 KY

Addresses

Primary practice location

1505 SW Cary Pkwy
Suite 302
Cary, NC 27511-6219

Mailing address

1505 SW Cary Pkwy
Suite 302
Cary, NC 27511-6219
Phone (919) 367-2580

Other identifiers 3

IdentifierTypeStateIssuer
0385104MedicaidOH
3810002481MedicaidWV
64164064MedicaidKY

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16406KYMDSurgery Physician
17366NCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Vascular Surgery and PastSince Dec 30, 2002 Accepting new patients
Rex Hospital, Inc. Past Accepting new patients
Rex Physicians LLC Past Accepting new patients
Wound Care Physicians PA Past Accepting new patients
Kenneth R. Hauswald Surgery PastSince Jan 1, 1990 Accepting new patients
Christopher T Bailey DO PLLC Surgery Past Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236038400000",
    "number": "1245236124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 SW CARY PKWY",
            "address_2": "SUITE 302",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275116219",
            "telephone_number": "919-367-2580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 SW CARY PKWY",
            "address_2": "SUITE 302",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275116219",
            "telephone_number": "919-367-2580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUSWALD",
        "first_name": "KENNETH",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2009-03-03",
        "deactivation_date": "2006-03-16",
        "reactivation_date": "2006-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "17366",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "16406",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0385104",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810002481",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64164064",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2009; 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.