Individual provider Active NPI

Catherine Jo Hauck, PA

  • Surgical Physician Assistant
  • Dayton, OH
National Provider Identifier
1740519693
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
50.0051272RX Issued in OH
Practice address
425 W Grand Ave Ste 2002
Dayton, OH 45405-4722
Phone
(937) 294-3611
NPI assigned
Dec 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 50.005127RX OH
Surgical Physician Assistant 363AS0400X 0010-02080 NC
Surgical Physician Assistant 363AS0400X 50.0051272RX OH Primary

Addresses

Primary practice location

425 W Grand Ave Ste 2002
Dayton, OH 45405-4722

Mailing address

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538-9071
Phone (970) 624-4451

Other practice location 1

257 McDowell St
Asheville, NC 28803-2606
Phone (828) 258-1121

Other identifiers 1

IdentifierTypeStateIssuer
0231295MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/
Direct Messaging Address chauck595504@direct.ketteringhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, CO, WA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20170719002559 OH Practitioner - Physician Assistant 4789715392 Reassigns benefits to 2 organizations
I20180608000274 CO Practitioner - Physician Assistant 4789715392 Reassigns benefits to 1 organization
I20250423000752 WA Practitioner - Physician Assistant 4789715392 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
George Washington University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services-WaGroup PAC ID 7911069703, 25 clinicians
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

101 W 8TH Ave
Spokane, WA 99204-2307
Phone (509) 474-3131

1400 E Boulder
Suite 2410 Pre Procedure Memorial
Colorado Springs, CO 80909-5533
Phone (719) 365-6525

1400 E Boulder St
Colorado Springs, CO 80909-5533

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

62 W 7TH Ave
Spokane, WA 99204-2321

Hospital & facility affiliations

  • Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022
  • Prov Sacred HRT Med Ctr & Childs Hosp. Hospital, Spokane, WA, CCN 500054

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.005127RXOHMDMedical Physician Assistant
50.0051272RXOHMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Apr 24, 2018 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Apr 24, 2018 Accepting new patients
Alliance Physicians Inc CurrentSince Aug 1, 2017 Accepting new patients
Kadlec Regional Medical Center Past Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

1400 E Boulder St
Ste 700
Colorado Springs, CO 80909
Phone (719) 365-7172

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

1400 E Boulder St
Ste 1183
Colorado Springs, CO 80909
Phone (719) 365-6999

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

425 W Grand Ave
Ste 2002
Dayton, OH 45405
Phone (937) 294-3611

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

1625 S Alex Rd
West Carrollton, OH 45449
Phone (937) 865-0534

Organizations & group practices 6

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.

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1261526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1740519693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE",
            "address_2": "STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389071",
            "telephone_number": "970-624-4451",
            "fax_number": "970-490-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W GRAND AVE STE 2002",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454054722",
            "telephone_number": "937-294-3611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "257 McDowell St",
            "address_purpose": "LOCATION",
            "city": "Asheville",
            "state": "NC",
            "postal_code": "288032606",
            "country_code": "US",
            "telephone_number": "828-258-1121",
            "fax_number": "828-252-6114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAUCK",
        "first_name": "CATHERINE",
        "middle_name": "JO",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-23",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50.005127RX",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-02080",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50.0051272RX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0231295",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "425 W Grand Ave Ste 2002",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454054722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chauck595504@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "425 W Grand Ave Ste 2002",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454054722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.