Jeffrey J. Haggenjos, D.O., Inc

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

JEFFREY J. HAGGENJOS, D.O., INC

Practice address

399 Lincoln Park Dr Ste a
New Lexington, OH 43764-1078

Phone

(740) 343-4447

Fax

(740) 343-4451

NPI assigned

Mar 25, 2019

Organization subpart

No

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

Authorized official

Name

Beverly Trovato

Title

Office Manager

Phone

(740) 343-4447

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Rural health clinic certification: CCN 363872

Legal name

JEFFREY J HAGGENJOS DO INC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Jul 16, 2018

Last certification

Jul 16, 2018

Ownership / control type

1A

Facility address

399 Lincoln Park Drive Suite a
New Lexington, OH 43764

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553558400000",
    "number": "1649730581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 LINCOLN PARK DR STE A",
            "city": "NEW LEXINGTON",
            "state": "OH",
            "postal_code": "437641078",
            "telephone_number": "740-343-4447",
            "fax_number": "740-343-4451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 LINCOLN PARK DR STE A",
            "city": "NEW LEXINGTON",
            "state": "OH",
            "postal_code": "437641078",
            "telephone_number": "740-343-4447",
            "fax_number": "740-343-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY J. HAGGENJOS, D.O., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-25",
        "last_updated": "2019-03-26",
        "status": "A",
        "authorized_official_last_name": "TROVATO",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "740-343-4447"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "haggenjospractice@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "399 Lincoln Park Dr Ste A",
            "city": "New Lexington",
            "state": "OH",
            "country_code": "US",
            "postal_code": "437641078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dorothy Ann James, M.ED., LPCC-S
• JDC Medical Inc
• JDS Medical Inc
• JDS Meical Inc
• Jeffrey J. Haggenjos, D.O., Inc
• Julie Ann Jenks, DMD
• Samantha L Jerles
• Heather Nichole Jewell
• John L Johnston, LPCC
• Roberta Kay Joy, COTA/L

• Rural Health Clinic/Center in New Lexington, OH
• Providers in New Lexington, OH by specialty
• Rural Health Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.