Phil Stephen Haggerty, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5426482-1204 Issued in UT

Practice address

461 E 200 S
Suite 100
Salt Lake City, UT 84111-2102

Phone

(801) 949-8312

Fax

(801) 553-9562

NPI assigned

Aug 12, 2005

Sex

Male

Sole proprietor

No

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 MT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services MtGroup PAC ID 6608786306, 358 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St. Patrick Hospital Hospital, Missoula, MT, CCN 270014

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/b2651172-99ed-43dd-9814-59d9dbd8df43/
• Direct secure messaging: phaggerty396753@wm.providencedirect.org

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.

• Providence Health & Services Mt

  • Rehabilitation Hospital Unit
  • Missoula, MT
  • NPI 1144319138
  Medicare reassignment Care Compare group NPD
• Providence Health & Services Mt

  • General Acute Care Hospital
  • Stevensville, MT
  • NPI 1053613356
  NPD
• Providence Health & Services Mt

  • Family Medicine Physician
  • Missoula, MT
  • NPI 1215222617
  NPD
• Evolutionary Healthcare LLC

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1851349344
  NPD (past)
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)
• Providence Health & Services Mt

  • Pulmonary Disease Physician
  • Missoula, MT
  • NPI 1427096585
  NPD (past)
• Sapphire Community Health Inc

  • Federally Qualified Health Center (FQHC)
  • Hamilton, MT
  • NPI 1003146812
  NPD (past)

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

• Providence Health & Services Mt

  • General Acute Care Hospital
  • Missoula, MT
  • NPI 1023032588
  Care Compare affiliation
• Providence Health & Services Mt

  • Medical Oncology Physician
  • Missoula, MT
  • NPI 1326483587

  Hospital

  Care Compare affiliation
• Providence Health & Services Mt

  • Anatomic Pathology & Clinical Pathology Physician
  • Missoula, MT
  • NPI 1366185928

  Hospital

  Care Compare affiliation
• Providence Health & Services Mt

  • Psychiatric Hospital Unit
  • Missoula, MT
  • NPI 1619058302
  Care Compare affiliation

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1922000496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 E 200 S",
            "address_2": "SUITE 100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841112102",
            "telephone_number": "801-949-8312",
            "fax_number": "801-553-9562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 E 200 S",
            "address_2": "SUITE 100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841112102",
            "telephone_number": "801-949-8312",
            "fax_number": "801-553-9562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGGERTY",
        "first_name": "PHIL",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "5426482-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Synneva Hagen-Lillevik, MS, RD, CD
• Jolena Ann Hagen, PHARM.D.
• Cameron Phillip Hagenson
• Susan J Hager, O.T.
• Maeve Magdalena Haggerty
• Nekisa Haghighat, MD, MPH
• Christine Rae Hagler, LMT
• Emily Elisabeth Hagn, M.D.
• Connor Hague, MD
• Karen Hague

• Family Medicine Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.