Nancy R. Haworth, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

23779 Issued in WI

Practice address

17000 W North Ave
Suite 110E
Brookfield, WI 53005-4423

Phone

(262) 786-8199

NPI assigned

May 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Ascension Medical Group-Southeast Wisconsin Inc

  • Internal Medicine Physician
  • Glendale, WI
  • NPI 1609881077
  Medicare reassignment NPD
• Elmbrook Pediatrics

  • Pediatric Adolescent Medicine Physician
  • Brookfield, WI
  • NPI 1801853387
  NPD (past) Authorized official

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306803408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 W NORTH AVE",
            "address_2": "SUITE 110E",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054423",
            "telephone_number": "262-786-8199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17000 W NORTH AVE",
            "address_2": "SUITE 110E",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054423",
            "telephone_number": "262-786-8199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWORTH",
        "first_name": "NANCY",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "WI",
            "license": "23779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Hausman, LPC
• Kevin J Havelka, RPH
• Howard Joel Haven, PHD
• Kelly Ann Hawkins, APSW
• Kevin Haworth, PH.D.
• Rylie Hayes
• Theresa K Hayssen, MD
• Healing Corner, LLC
• Healing Hearts Wellness LLC
• Healthdirect Institutional Pharmacy Services, Inc.

• Pediatric Adolescent Medicine Physician in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Pediatric Adolescent Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.