Active NPI
Theodore Vincent Haas, MD
- Obstetrics & Gynecology Physician
- Ottumwa, IA
National Provider Identifier
1770587701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 20687
- Practice address
- 1005 Pennsylvania Ave
Ste 204
Ottumwa, IA 52501-6414 - Phone
- (641) 682-8761
- Fax
- (641) 682-2764
- NPI assigned
- Jun 8, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 20687 | IA | Primary |
Addresses
Primary practice location
1005 Pennsylvania Ave
Ste 204
Ottumwa, IA 52501-6414
Mailing address
1005 Pennsylvania Ave
Ste 204
Ottumwa, IA 52501-6414
Phone (641) 682-8761
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0173138 | Medicaid | IA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20687 | IA | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194480000000",
"number": "1770587701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1005 PENNSYLVANIA AVE",
"address_2": "STE 204",
"city": "OTTUMWA",
"state": "IA",
"postal_code": "525016414",
"telephone_number": "641-682-8761",
"fax_number": "641-682-2764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 PENNSYLVANIA AVE",
"address_2": "STE 204",
"city": "OTTUMWA",
"state": "IA",
"postal_code": "525016414",
"telephone_number": "641-682-8761",
"fax_number": "641-682-2764"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAAS",
"first_name": "THEODORE",
"middle_name": "VINCENT",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-08",
"last_updated": "2007-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "IA",
"license": "20687",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0173138",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ottumwa, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 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.