Individual provider Active NPI

Beth Ann Haselhorst, MD

  • Family Medicine Physician
  • Usaf Academy, CO
National Provider Identifier
1700895869
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
44306 Issued in CO
Practice address
4102 Pinion Dr
Cadet Clinic - 10TH Medical Group
Usaf Academy, CO 80840-4000
Phone
(719) 333-5180
NPI assigned
Aug 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 44306 CO Primary

Addresses

Primary practice location

4102 Pinion Dr
Cadet Clinic - 10TH Medical Group
Usaf Academy, CO 80840-4000

Mailing address

2250 Oak Hills Dr
Colorado Springs, CO 80919-3472
Phone (719) 522-1444

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
44306COMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700895869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 OAK HILLS DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809193472",
            "telephone_number": "719-522-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 PINION DR",
            "address_2": "CADET CLINIC - 10TH MEDICAL GROUP",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "808404000",
            "telephone_number": "719-333-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASELHORST",
        "first_name": "BETH",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "44306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Usaf Academy, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.