Richard Ted Haber

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

5654 Roosevelt Blvd
Dearborn Heights, MI 48125-2584

Phone

(313) 303-1572

NPI assigned

May 4, 2023

Last updated

May 4, 2023By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1683158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1881383925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5654 ROOSEVELT BLVD",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481252584",
            "telephone_number": "313-303-1572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5654 ROOSEVELT BLVD",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481252584",
            "telephone_number": "313-303-1572"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8900 e.jefferson",
            "address_2": "detroit",
            "address_purpose": "LOCATION",
            "city": "detroit",
            "state": "MI",
            "postal_code": "48214",
            "country_code": "US",
            "telephone_number": "313-331-1698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HABER",
        "first_name": "RICHARD",
        "middle_name": "TED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-04",
        "last_updated": "2023-05-04",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Dearborn Heights, MI
• Providers in Dearborn Heights, MI by specialty
• Athletic Trainer in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; 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.