Matthew T Hafen, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

9761461202 Issued in UT

Practice address

1054 E Riverside Dr Ste 202
St George, UT 84790-4829

Phone

(435) 673-0900

Fax

(435) 359-5102

NPI assigned

Apr 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Willow Bend Chiropractic LLCGroup PAC ID 2264448612, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Willow Bend Chiropractic, LLC

  • Chiropractor
  • St George, UT
  • NPI 1619131042
  Medicare reassignment Care Compare group Authorized official

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1861459786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1054 E RIVERSIDE DR STE 202",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847904829",
            "telephone_number": "435-673-0900",
            "fax_number": "435-359-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1054 E RIVERSIDE DR STE 202",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847904829",
            "telephone_number": "435-673-0900",
            "fax_number": "435-359-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFEN",
        "first_name": "MATTHEW",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "9761461202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Preston Hadlock, PHARMD
• Trevor Nathanael Haerle
• Brooklyn Sage Hafen
• KC Hafen, PA
• Kyna Hafen
• Rosalee Angel Hafen
• Tamalyn Hafen
• Tyrone Troy Hafen
• Elizabrth Hagen, N/A
• Jerold L Hagen, MD

• Chiropractor in St George, UT
• Providers in St George, UT by specialty
• Chiropractor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.