Haggarddpm Home Foot Care LLC

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

Legal business name

HAGGARDDPM HOME FOOT CARE LLC

Practice address

210 27TH Ave Apt F105
Milton, WA 98354-8330

Phone

(253) 334-5262

Fax

(253) 815-1651

NPI assigned

Nov 26, 2019

Last updated

Nov 26, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stephen Haggard, DPMNPI 1134154032

Title

Sole Member

Phone

(253) 334-5262

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephen Haggard, DPM PS

  • Primary Podiatric Medicine Podiatrist
  • Milton, WA
  • NPI 1134154032
  NPD Authorized official

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

{
    "created_epoch": "1574726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574726400000",
    "number": "1619513488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 506",
            "city": "MILTON",
            "state": "WA",
            "postal_code": "983540506",
            "telephone_number": "253-334-5262",
            "fax_number": "253-815-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 27TH AVE APT F105",
            "city": "MILTON",
            "state": "WA",
            "postal_code": "983548330",
            "telephone_number": "253-334-5262",
            "fax_number": "253-815-1651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAGGARDDPM HOME FOOT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-26",
        "last_updated": "2019-11-26",
        "status": "A",
        "authorized_official_last_name": "HAGGARD",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "253-334-5262",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063510",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drhaggard@haggarddpm.com",
            "affiliation": "N",
            "endpointDescription": "encrypted email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "send encrypted information",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "emcrypted information",
            "address_1": "210 27th Ave Apt F105",
            "city": "Milton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983548330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer S. Gonzalez, M.S. CCC-SLP
• Gena Granstrom, LMP
• Zhanna Gudzyuk, NP
• Garard Melvin Gustafson, O.D.
• Stephen Haggard, DPM PS
• Brandy Rae Harteau
• John Heckel
• Michelle Heinrich
• Mark Hennecken, LPN
• David Hensley, D.D.S.

• Podiatric Clinic/Center in Milton, WA
• Providers in Milton, WA by specialty
• Podiatric Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; 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.