Individual provider Active NPI

Kristi A. Haan, PA-C

  • Physician Assistant
  • Grand Junction, CO
National Provider Identifier
1609859164
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0001377 Issued in CO
Practice address
1120 Wellington Ave
Grand Junction, CO 81501-6129
Phone
(970) 241-6011
Fax
(970) 241-4650
NPI assigned
Nov 29, 2005
Last updated
Oct 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0001377 CO Primary

Addresses

Primary practice location

1120 Wellington Ave
Grand Junction, CO 81501-6129

Mailing address

PO Box 10700
Grand Junction, CO 81502-5517
Phone (970) 254-2642

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20101215001182 CO Practitioner - Physician Assistant 1153519269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Care Partners IncGroup PAC ID 7810893161, 58 clinicians

Practice addresses (Care Compare)

1120 Wellington Ave
Grand Junction, CO 81501-6129
Phone (970) 241-6011

3150 N 12TH St
Grand Junction, CO 81506-2863
Phone (970) 245-1220

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.0001377COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Partners, Inc. CurrentSince Oct 10, 2002 Accepting new patients
Primary Care Partners, Inc. Family Medicine CurrentSince Oct 10, 2002 Accepting new patients
Primary Care Partners, Inc. Past Accepting new patients

Locations

1120 Wellington Ave
Grand Junction, CO 81501
Phone (970) 241-0170

3150 N 12th St
Grand Junction, CO 81506
Phone (970) 241-5856

Interoperability endpoints

  • Direct secure messaging: kristihaan@pcp.allscriptsdirect.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1609859164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10700",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815025517",
            "telephone_number": "970-254-2642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 WELLINGTON AVE",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815016129",
            "telephone_number": "970-241-6011",
            "fax_number": "970-241-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAN",
        "first_name": "KRISTI",
        "middle_name": "A.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-29",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0001377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.