Kevin Hattaway, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DR.0049308 Issued in CO

Practice address

525 Hathaway Street
Fairplay, CO 80440

Phone

(303) 788-9220

NPI assigned

Mar 26, 2007

Last updated

Jul 26, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kevin.hattaway@hca3.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Madison Behavioral Health, LLC

  dba Madison Behavioral Health

  • Psychiatry Physician
  • Madison, TN
  • NPI 1891741450
  NPD (past)
• Madison Behavioral Health, LLC

  • Psychiatry Physician
  • Madison, TN
  • NPI 1912938515
  NPD (past)
• Premier Orthopaedics & Sports Medicine, PLC

  dba Hughston Clinic Orthopaedics

  • Durable Medical Equipment & Medical Supplies
  • Murfreesboro, TN
  • NPI 1861029084
  NPD (past)

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564099200000",
    "number": "1679691885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 HATHAWAY STREET",
            "city": "FAIRPLAY",
            "state": "CO",
            "postal_code": "80440",
            "telephone_number": "303-788-9220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 HATHAWAY STREET",
            "city": "FAIRPLAY",
            "state": "CO",
            "postal_code": "80440",
            "telephone_number": "303-788-9220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 Hathaway Street",
            "address_purpose": "LOCATION",
            "city": "Fairplay",
            "state": "CO",
            "postal_code": "80440",
            "country_code": "US",
            "telephone_number": "303-788-9220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HATTAWAY",
        "first_name": "KEVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2019-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "30152",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0049308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "3150572",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine M Fitting, M.D.
• Adam Fyler, MT-BC, LPCC
• GKH Holdings (Park County Audiology)
• Kelly Marie Halligan, AUD
• Sandra Kay Harshaw, RN
• Healthone Clinic Services - Cardiovascular LLC
• Healthone Clinic Services - Primary Care, LLC (South Park Health Care)
• Healthone Clinic Services-Surgical Specialties LLC
• High Mountain Hygiene, PC
• Samantha Irene Jager, LMT

• Family Medicine Physician in Fairplay, CO
• Providers in Fairplay, CO by specialty
• Family Medicine Physician in Colorado

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