Individual provider Active NPI

Christopher Muir Haymaker, PH.D.

  • Clinical Psychologist
  • Kalamazoo, MI
National Provider Identifier
1386682516
Registry record updated Dec 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301018417 Issued in MI
Practice address
1000 Oakland Dr
Kalamazoo, MI 49008-1282
Phone
(269) 387-7000
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 6301018417 MI
Clinical Psychologist 103TC0700X 6301018417 MI Primary

Addresses

Primary practice location

1000 Oakland Dr
Kalamazoo, MI 49008-1282

Mailing address

531 Jenks Blvd
Kalamazoo, MI 49006-3314
Phone (319) 269-6982

Other practice location 1

2055 Kimball Ave
Suite 101
Waterloo, IA 50702-5047
Phone (319) 272-2112

Other identifiers 3

IdentifierTypeStateIssuer
509060OtherVALUES OPTIONS
36263OtherIABLUE CROSS BLUE SHIELD
706558000MedicaidIA

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 Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Health Psychologists, PLC Clinical CurrentSince Dec 15, 2003 Accepting new patients
Western Michigan University School of Medicine PastSince Aug 18, 2012 Accepting new patients

Locations

3116 Brockway Rd
Waterloo, IA 50701
Phone (319) 226-5301

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1386682516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 JENKS BLVD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490063314",
            "telephone_number": "319-269-6982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 OAKLAND DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490081282",
            "telephone_number": "269-387-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2055 Kimball Ave",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Waterloo",
            "state": "IA",
            "postal_code": "507025047",
            "country_code": "US",
            "telephone_number": "319-272-2112",
            "fax_number": "319-272-2107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYMAKER",
        "first_name": "CHRISTOPHER",
        "middle_name": "MUIR",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MI",
            "license": "6301018417",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301018417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUES OPTIONS",
            "identifier": "509060",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "36263",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "706558000",
            "state": "IA"
        }
    ],
    "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 Dec 27, 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.