Jerry L. Haag, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MA02782500 Issued in NJ

Practice address

350 Front St
Elmer, NJ 08318-2143

Phone

(856) 358-8113

Fax

(856) 358-1305

NPI assigned

Jun 11, 2006

Last updated

Nov 19, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258588800000",
    "number": "1699717165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 FRONT ST",
            "city": "ELMER",
            "state": "NJ",
            "postal_code": "083182143",
            "telephone_number": "856-358-8113",
            "fax_number": "856-358-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 FRONT ST",
            "city": "ELMER",
            "state": "NJ",
            "postal_code": "083182143",
            "telephone_number": "856-358-8113",
            "fax_number": "856-358-1305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAG",
        "first_name": "JERRY",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-11",
        "last_updated": "2009-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA02782500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2196409",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Elmer, NJ
• Providers in Elmer, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2009; 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.