Havens Family Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

28791 Issued in CO

Legal business name

HAVENS FAMILY CLINIC

Practice address

109 Latigo LN
Suite C
Canon City, CO 81212-8112

Phone

(719) 276-3211

NPI assigned

Feb 19, 2007

Organization subpart

No

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

Authorized official

Name

Jason Morgan, PA

Title

Office Manager

Phone

(719) 276-3211

Specialties & licenses 3

Addresses

Other identifiers 3

Tax ID family

Havens Family Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Havens Family Clinic

  • Family Nurse Practitioner
  • Canon City, CO
  • NPI 1134249964
  NPD tax ID

Locations

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332460800000",
    "number": "1619011830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 LATIGO LN",
            "address_2": "SUITE C",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812128112",
            "telephone_number": "719-276-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 LATIGO LN",
            "address_2": "SUITE C",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812128112",
            "telephone_number": "719-276-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVENS FAMILY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2012-03-23",
        "status": "A",
        "authorized_official_last_name": "MORGAN",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "719-276-3211",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "28791",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "2124",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "NP4805",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1205816949",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74402374",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PROVIDER NPI",
            "identifier": "1831176924",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Todd Harrigan, M.D.
• Marci Lauree Harrison
• Anita Harvey
• Brent Alan Haskell, D.O.
• Havens Family Clinic
• Havens Family Clinic
• Amanda Hay, LCSW
• Health Seekers Enterprises PLLC
• Health Solutions Family Practice and Walk-in Clinic
• Hearts Made Happy, LLC

• Family Medicine Physician in Canon City, CO
• Providers in Canon City, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2012; 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.