Active NPI
Michelle R Hausheer, MD
- Psychiatry Physician
- Fayetteville, AR
National Provider Identifier
1912974577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 04-29570
- Practice address
- 1100 N College Ave
Fayetteville, AR 72703-1944 - Phone
- (479) 443-4301
- NPI assigned
- Mar 2, 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 04-29570 | KS | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | E-6923 | AR | |
| Psychiatry Physician | 2084P0800X | 04-29570 | KS | Primary |
| Neurodevelopmental Disabilities Physician | 2084P0005X | 04-29570 | KS |
Addresses
Primary practice location
1100 N College Ave
Fayetteville, AR 72703-1944
Mailing address
3605 SW Windy Way Ave
Bentonville, AR 72713-5563
Phone (479) 295-3516
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104222 | Other | KS | INDIV ID NUMBER BCBS |
| 111102 | Other | KS | BCBS OF KS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04-29570 | KS | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Guidance Center | Past | Accepting new patients | |
| Child Psychiatry LLC | Neurodevelopmental Disabilities | Past | Accepting new patients |
| Compass Behavioral Health | Past | Accepting new patients | |
| Southwest Guidance Center | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Psychiatry Physician
- Liberal, KS
- NPI 1568589570
Neurodevelopmental Disabilities
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Garden City, KS
- NPI 1922058510
-
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Liberal, KS
- NPI 1154421097
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Liberal, KS
- NPI 1801991203
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715558400000",
"number": "1912974577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3605 SW WINDY WAY AVE",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727135563",
"telephone_number": "479-295-3516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 N COLLEGE AVE",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727031944",
"telephone_number": "479-443-4301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAUSHEER",
"first_name": "MICHELLE",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-03-02",
"last_updated": "2024-05-13",
"certification_date": "2024-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "KS",
"license": "04-29570",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "AR",
"license": "E-6923",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "KS",
"license": "04-29570",
"primary": true
},
{
"code": "2084P0005X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
"state": "KS",
"license": "04-29570",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIV ID NUMBER BCBS",
"identifier": "104222",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF KS",
"identifier": "111102",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fayetteville, AR
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.