Active NPI
Haley Nicole Von Haven, PA-C
- Physician Assistant
- Pensacola, FL
National Provider Identifier
1265981476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9110516
- Practice address
- 9400 University Pkwy Ste 309
Pensacola, FL 32514-5485 - Phone
- (850) 479-3320
- Fax
- (850) 479-8789
- NPI assigned
- Sep 28, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Physician Assistant | 363A00000X | PA9110516 | FL | Primary |
Addresses
Primary practice location
9400 University Pkwy Ste 309
Pensacola, FL 32514-5485
Mailing address
PO Box 30532
Pensacola, FL 32503-1532
Phone (850) 479-3320
Other practice location 1
2105 E South Blvd
Montgomery, AL 36116-2409
Phone (334) 288-2100
Other practice location 2
2105 E South Blvd
Montgomery, AL 36116-2409
Phone (334) 288-2100
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9110516 | FL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1265981476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 30532",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325031532",
"telephone_number": "850-479-3320",
"fax_number": "850-479-8789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9400 UNIVERSITY PKWY STE 309",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325145485",
"telephone_number": "850-479-3320",
"fax_number": "850-479-8789"
}
],
"practiceLocations": [
{
"address_1": "2105 E South Blvd",
"address_purpose": "LOCATION",
"city": "Montgomery",
"state": "AL",
"postal_code": "361162409",
"country_code": "US",
"telephone_number": "334-288-2100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2105 E South Blvd",
"address_purpose": "LOCATION",
"city": "Montgomery",
"state": "AL",
"postal_code": "361162409",
"country_code": "US",
"telephone_number": "334-288-2100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VON HAVEN",
"first_name": "HALEY",
"middle_name": "NICOLE",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-28",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9110516",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pensacola, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.