Active NPI
Christine L. Haack, MSPT
- Physical Therapist
- Bloomington, IN
National Provider Identifier
1619196458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05002800A
- Practice address
- 2420 E Maxwell LN
Bloomington, IN 47401-6192 - Phone
- (812) 331-7255
- NPI assigned
- Apr 24, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05002800A | IN | Primary |
Addresses
Primary practice location
2420 E Maxwell LN
Bloomington, IN 47401-6192
Mailing address
2605 E Creeks Edge Dr
Bloomington, IN 47401-8368
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05002800A | IN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519689600000",
"number": "1619196458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2605 E CREEKS EDGE DR",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474018368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2420 E MAXWELL LN",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474016192",
"telephone_number": "812-331-7255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAACK",
"first_name": "CHRISTINE",
"middle_name": "L.",
"credential": "MSPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-24",
"last_updated": "2018-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05002800A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.