Individual provider Active NPI

Elizabeth Haworth-Hoeppner, M.D.

  • Pediatrics Physician
  • Kalamazoo, MI
National Provider Identifier
1700265816
Registry record updated Jan 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301116018 Issued in MI
Practice address
601 John St # 55
Kalamazoo, MI 49007-5341
Phone
(269) 341-8986
NPI assigned
May 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 4301116018 MI Primary

Addresses

Primary practice location

601 John St # 55
Kalamazoo, MI 49007-5341

Mailing address

601 John St # 55
Kalamazoo, MI 49007-5341

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct Bronson Healthcare Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180914001607 MI Practitioner - Pediatric Medicine 8729339627 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Medical Practices CurrentSince Sep 5, 2019 Accepting new patients
Bronson Methodist Hospital CurrentSince Sep 3, 2018 Accepting new patients
Lakeland Medical Practices CurrentSince Sep 5, 2019 Accepting new patients
Bronson Methodist Hospital Past Accepting new patients

Locations

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

601 John St
Ste E352
Kalamazoo, MI 49007
Phone (269) 341-6475

601 John St
#55
Kalamazoo, MI 49007
Phone (269) 341-7597

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

Interoperability endpoints

  • Direct secure messaging: direct@direct.bronsonhg.org

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1432166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1700265816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 JOHN ST # 55",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 JOHN ST # 55",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341",
            "telephone_number": "269-341-8986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWORTH-HOEPPNER",
        "first_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-21",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301116018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "affiliationName": "Bronson Healthcare Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.