Active NPI
Brent Alan Haskell, D.O.
- Neuromusculoskeletal Medicine & OMM Physician
- Canon City, CO
National Provider Identifier
1639131220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neuromusculoskeletal Medicine & OMM Physician
- License
- 34749
- Practice address
- 1338 Phay Ave
Canon City, CO 81212-2302 - Phone
- (719) 285-2646
- Fax
- (719) 285-2647
- NPI assigned
- Apr 6, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Neuromusculoskeletal Medicine & OMM Physician | 204D00000X | 34749 | CO | Primary |
Addresses
Primary practice location
1338 Phay Ave
Canon City, CO 81212-2302
Mailing address
1338 Phay Ave
Canon City, CO 81212-2302
Phone (719) 285-2646
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13329 | Other | CO | CO ANTHEM PIN |
| 89F14HA | Other | CO | BCBS OF MINN. PIN |
| P00027804 | Other | CO | RAILROAD MEDICARE PIN |
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
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354838400000",
"number": "1639131220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1338 PHAY AVE",
"city": "CANON CITY",
"state": "CO",
"postal_code": "812122302",
"telephone_number": "719-285-2646",
"fax_number": "719-285-2647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1338 PHAY AVE",
"city": "CANON CITY",
"state": "CO",
"postal_code": "812122302",
"telephone_number": "719-285-2646",
"fax_number": "719-285-2647"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HASKELL",
"first_name": "BRENT",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-06",
"last_updated": "2012-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "204D00000X",
"taxonomy_group": "",
"desc": "Neuromusculoskeletal Medicine & OMM",
"state": "CO",
"license": "34749",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CO ANTHEM PIN",
"identifier": "13329",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MINN. PIN",
"identifier": "89F14HA",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE PIN",
"identifier": "P00027804",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Canon City, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.