Individual provider Active NPI

Abigail R. Haselden, M.D.

  • Pediatrics Physician
  • Fort Wayne, IN
National Provider Identifier
1780926618
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01077314A Issued in IN
Practice address
7910 W Jefferson Blvd Ste 201
Fort Wayne, IN 46804-4159
Phone
(260) 436-3789
Fax
(260) 436-2703
NPI assigned
Mar 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01077314A IN Primary

Addresses

Primary practice location

7910 W Jefferson Blvd Ste 201
Fort Wayne, IN 46804-4159

Mailing address

7910 W Jefferson Blvd Ste 201
Fort Wayne, IN 46804-4159
Phone (260) 436-3789

Other names 1

  • Mrs. Abigail R Kleber Professional name

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
01077314AINMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Associates Inc Pediatrics CurrentSince Apr 14, 2024 Accepting new patients

Locations

7910 W Jefferson Blvd
Ste 201
Fort Wayne, IN 46804
Phone (260) 436-3789

Interoperability endpoints

  • Direct secure messaging: ahaselden@paik.ssdirect.aprima.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/1ba56762-29f3-48fc-ab7a-bea5f733932b/

Organizations & group practices 1

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": "1363564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1780926618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7910 W JEFFERSON BLVD STE 201",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044159",
            "telephone_number": "260-436-3789",
            "fax_number": "260-436-2703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7910 W JEFFERSON BLVD STE 201",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044159",
            "telephone_number": "260-436-3789",
            "fax_number": "260-436-2703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASELDEN",
        "first_name": "ABIGAIL",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-18",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01077314A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABIGAIL",
            "last_name": "KLEBER",
            "middle_name": "R",
            "prefix": "MRS.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.