Individual provider Active NPI

Erin Marie Haggerty, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Provo, UT
National Provider Identifier
1598993040
Registry record updated Nov 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
349677-4405 Issued in UT
Practice address
619 N 500 W
Provo, UT 84601-1547
Phone
(801) 852-9440
Fax
(801) 852-9449
NPI assigned
Jun 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 349677-4405 UT Primary

Addresses

Primary practice location

619 N 500 W
Provo, UT 84601-1547

Mailing address

619 N 500 W
Provo, UT 84601-1547
Phone (801) 852-9440

Other names 1

  • Erin Marie Haggerty Professional name

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20141105002452 UT Practitioner - Nurse Practitioner 0547482606 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peak ENT Associates CurrentSince Nov 1, 2016 Accepting new patients
Physician Group of Utah Inc CurrentSince Aug 1, 2014 Accepting new patients

Locations

1055 N 300 W
Ste 401
Provo, UT 84604
Phone (801) 375-4646

619 N 500 W
Provo, UT 84601
Phone (801) 420-0465

1377 E 3900 S
Ste 200
Salt Lake Cty, UT 84124
Phone (385) 743-1051

2530 W 4700 S
Ste B8
Taylorsville, UT 84129
Phone (801) 967-5866

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

Interoperability endpoints

  • Direct secure messaging: erin.haggerty@10740.chartlogic.direct-ci.com

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": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1598993040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 N 500 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011547",
            "telephone_number": "801-852-9440",
            "fax_number": "801-852-9449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 N 500 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011547",
            "telephone_number": "801-852-9440",
            "fax_number": "801-852-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGGERTY",
        "first_name": "ERIN",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-23",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "349677-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "HAGGERTY",
            "middle_name": "MARIE",
            "credential": "APRN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.