Stephen Glenn Haubrock, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

0027935 Issued in OH

Practice address

2990 Mack Rd Ste 107
Fairfield, OH 45014-5384

Phone

(513) 860-4801

NPI assigned

Dec 27, 2020

Sex

Male

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 OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Gcga Physicians Inc.

  • Gastroenterology Physician
  • Cincinnati, OH
  • NPI 1790851095
  Medicare reassignment NPD
• Liberty Endoscopy Center

  • Ambulatory Surgical Clinic/Center
  • Liberty Township, OH
  • NPI 1598275703
  NPD (past)

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

{
    "created_epoch": "1609027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609027200000",
    "number": "1447847389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6558 PARTRIDGE WAY",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450407009",
            "telephone_number": "513-560-6414",
            "fax_number": "513-682-4186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 MACK RD STE 107",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145384",
            "telephone_number": "513-860-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUBROCK",
        "first_name": "STEPHEN",
        "middle_name": "GLENN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-27",
        "last_updated": "2020-12-27",
        "certification_date": "2020-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "0027935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Hartmann, PH.D
• Caroline N Harty
• Jennifer S. Haskell, M.D.
• Erika Hatfield
• Ronald Hathaway, DDS
• Deborah A Hauger, M.D.
• Lauren Karyn Hauger
• Estefania Cristina Hawayek de Paz
• Mallory M Hayes
• Renee Elizabeth Hayes, PHARMD

• Nurse Practitioner in Fairfield, OH
• Providers in Fairfield, OH by specialty
• Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2020; 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.