NPIMap

Individual provider Active NPI

Jennifer L. Haugen, PA

  • Physician Assistant
  • Mint Hill, NC
National Provider Identifier
1871500553
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
102061 Issued in NC
Practice address
11304 Hawthorne Dr
Ste 100
Mint Hill, NC 28227-9425
Phone
(704) 545-6400
NPI assigned
Aug 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 102061 NC Primary

Addresses

Primary practice location

11304 Hawthorne Dr
Ste 100
Mint Hill, NC 28227-9425

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

1802 E Main St
Lincolnton, NC 28092-3915
Phone (980) 212-2610

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jhaugen128578@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041119000888 NC Practitioner - Physician Assistant 7810952751 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Emory University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

11304 Hawthorne Dr
Suite 100
Mint Hill, NC 28227-9437
Phone (704) 545-6400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
102061NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Mar 23, 2013 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Mar 23, 2013 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

9332 S Tryon St
Charlotte, NC 28273
Phone (704) 587-6700

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

5717 Albemarle Rd
Charlotte, NC 28212
Phone (704) 563-2150

1802 E Main St
Lincolnton, NC 28092
Phone (980) 212-2610

11304 Hawthorne Dr
Ste 100
Mint Hill, NC 28227
Phone (704) 384-8760

1550 Faulk St
Ste 1500
Monroe, NC 28112
Phone (704) 302-9700

Interoperability endpoints

  • Direct secure messaging: jhaugen128578@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 5

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1871500553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11304 HAWTHORNE DR",
            "address_2": "STE 100",
            "city": "MINT HILL",
            "state": "NC",
            "postal_code": "282279425",
            "telephone_number": "704-545-6400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1802 E Main St",
            "address_purpose": "LOCATION",
            "city": "Lincolnton",
            "state": "NC",
            "postal_code": "280923915",
            "country_code": "US",
            "telephone_number": "980-212-2610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAUGEN",
        "first_name": "JENNIFER",
        "middle_name": "L.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "102061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhaugen128578@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "11304 Hawthorne Dr",
            "address_2": "Ste 100",
            "city": "Mint Hill",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282279425",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mint Hill, NC

Sources for this page

Verify at the official NPI Registry.