Active NPI
Mary C Hafer, MD
- Obstetrics & Gynecology Physician
- Meridian, ID
National Provider Identifier
1861449084
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- M7753
- Practice address
- 2971 E Copper Point Dr
Ste # 125
Meridian, ID 83642-5101 - Phone
- (208) 893-5383
- Fax
- (208) 893-5386
- NPI assigned
- May 31, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | M7753 | ID | Primary |
Addresses
Primary practice location
2971 E Copper Point Dr
Ste # 125
Meridian, ID 83642-5101
Mailing address
2971 E Copper Point Dr
Ste # 125
Meridian, ID 83642-5101
Phone (208) 893-5383
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| M7753 | Other | ID | IDAHO STATE MEDICAL LICEN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Mar 7, 2016 through Mar 7, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M7753 | ID | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1861449084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2971 E COPPER POINT DR",
"address_2": "STE # 125",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836425101",
"telephone_number": "208-893-5383",
"fax_number": "208-893-5386"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2971 E COPPER POINT DR",
"address_2": "STE # 125",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836425101",
"telephone_number": "208-893-5383",
"fax_number": "208-893-5386"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAFER",
"first_name": "MARY",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-31",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "ID",
"license": "M7753",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IDAHO STATE MEDICAL LICEN",
"identifier": "M7753",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.