Individual provider Active NPI

Kathryn Jean Hafer, DC

  • Chiropractor
  • Kalamazoo, MI
National Provider Identifier
1255365359
Registry record updated Sep 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301300275 Issued in MI
Practice address
1122 S Westnedge
Kalamazoo, MI 49008
Phone
(269) 383-4325
Fax
(269) 383-4325
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301300275 MI Primary

Addresses

Primary practice location

1122 S Westnedge
Kalamazoo, MI 49008

Mailing address

1122 S Westnedge
Kalamazoo, MI 49008
Phone (269) 383-4325

Other identifiers 3

IdentifierTypeStateIssuer
3455962MedicaidMI
950C950120OtherMIBCROSS
P71224OtherMIBSHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150529000272 MI Practitioner - Chiropractic 5991834913 Practice locations: Kalamazoo, MI; Allegan, MI

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1122 S Westnedge
Healing Center
Kalamazoo, MI 49008-1350
Phone (269) 383-4325

1122 S Westnedge Ave
Kalamazoo, MI 49008-1350

500 Linn St
Ofc 2
Allegan, MI 49010-1581
Phone (269) 673-5426

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Center Chiropractor PastSince Apr 7, 2012 Accepting new patients
David P and Mona E Ruse Chiropractor Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379980800000",
    "number": "1255365359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 S WESTNEDGE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "49008",
            "telephone_number": "269-383-4325",
            "fax_number": "616-396-0486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 S WESTNEDGE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "49008",
            "telephone_number": "269-383-4325",
            "fax_number": "269-383-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFER",
        "first_name": "KATHRYN",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2013-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301300275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3455962",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCROSS",
            "identifier": "950C950120",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSHIELD",
            "identifier": "P71224",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.