Craig Allan Havermann, PTA

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

001279 Issued in IA

Practice address

202 10TH Street SE
Cedar Rapids, IA 52403-2404

Phone

(319) 398-1506

Fax

(319) 558-4062

NPI assigned

Jul 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378857600000",
    "number": "1912924358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3178",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524063178",
            "telephone_number": "319-398-1583",
            "fax_number": "319-399-2085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 10TH STREET SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524032404",
            "telephone_number": "319-398-1506",
            "fax_number": "319-558-4062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVERMANN",
        "first_name": "CRAIG",
        "middle_name": "ALLAN",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2013-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IA",
            "license": "00156",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IA",
            "license": "001279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA LICENSE, ATC",
            "identifier": "00156",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATA MEMBER #",
            "identifier": "960644",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATABOC #",
            "identifier": "089702522",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amie Hass, ARNP
• Maysar Hassan, MD
• Shauna Rae Hatchitt, ARNP
• Ross Hauser
• April Lynn Haven, ARNP
• Austin Michael Havertape
• Mark Allan Havertape, D.C.
• Norma Havlik-Smith
• Patrick J Hawkes, M.D.
• Hawkeye Anesthesia PLLC

• Athletic Trainer in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Athletic Trainer in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2013; 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.