Active NPI
Theodore Haglund, MD
- Family Medicine Physician
- Madison, WI
National Provider Identifier
1821017666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 28364
- Practice address
- 675 W Washington Ave
Madison, WI 53703-2637 - Phone
- (608) 257-9700
- NPI assigned
- Jul 19, 2006
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 28364 | WI | Primary |
Addresses
Primary practice location
675 W Washington Ave
Madison, WI 53703-2637
Mailing address
1265 John Q Hammons Dr
Madison, WI 53717-1941
Phone (608) 251-4156
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30846400 | Medicaid | WI |
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 |
|---|---|---|---|
| 28364 | WI | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348531200000",
"number": "1821017666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1265 JOHN Q HAMMONS DR",
"city": "MADISON",
"state": "WI",
"postal_code": "537171941",
"telephone_number": "608-251-4156",
"fax_number": "608-257-3842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "675 W WASHINGTON AVE",
"city": "MADISON",
"state": "WI",
"postal_code": "537032637",
"telephone_number": "608-257-9700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAGLUND",
"first_name": "THEODORE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-19",
"last_updated": "2012-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "28364",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30846400",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.