Active NPI
Nancy Rutledge Haggart, PT
- Physical Therapist
- Detroit Lakes, MN
National Provider Identifier
1649227257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1372
- Practice address
- 633 Shorewood Dr
Detroit Lakes, MN 56501-4601 - Phone
- (218) 849-6949
- NPI assigned
- May 28, 2006
- Last updated
- Sep 3, 2013
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1372 | MN | Primary |
Addresses
Primary practice location
633 Shorewood Dr
Detroit Lakes, MN 56501-4601
Mailing address
633 Shorewood Dr
Detroit Lakes, MN 56501-4601
Phone (218) 849-6949
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 974511 | Other | MN | AMERICA'S PPO/ARAZ # |
| 16145 | Other | MN | NDBS # |
| DA9031015523 | Other | MN | PREFERRED ONE # |
| 6411644 | Other | MN | MEDICA # |
| 59D56HA | Other | MN | MNBS # |
| HP38653 | Other | FM | HEALTHPARTNERS # |
| MN200044 | Other | MN | LHS/BANNERHEALTH # |
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 |
|---|---|---|---|
| 1372 | MN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378166400000",
"number": "1649227257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "633 SHOREWOOD DR",
"city": "DETROIT LAKES",
"state": "MN",
"postal_code": "565014601",
"telephone_number": "218-849-6949"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "633 SHOREWOOD DR",
"city": "DETROIT LAKES",
"state": "MN",
"postal_code": "565014601",
"telephone_number": "218-849-6949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAGGART",
"first_name": "NANCY",
"middle_name": "RUTLEDGE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-28",
"last_updated": "2013-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "1372",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICA'S PPO/ARAZ #",
"identifier": "974511",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NDBS #",
"identifier": "16145",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE #",
"identifier": "DA9031015523",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA #",
"identifier": "6411644",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MNBS #",
"identifier": "59D56HA",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS #",
"identifier": "HP38653",
"state": "FM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LHS/BANNERHEALTH #",
"identifier": "MN200044",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Detroit Lakes, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.