Kelly J Hauck, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

AP114586 Issued in TX

Practice address

1500 Citywest Blvd
Ste. 300
Houston, TX 77042

Phone

(713) 620-4000

Fax

(713) 458-4229

NPI assigned

Jul 29, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Kelly J Bergman Former name

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MHC Anesthesia ServicesGroup PAC ID 2860383296, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• MHC Anesthesia Services

  • Anesthesiology Physician
  • Sioux City, IA
  • NPI 1639244270
  Medicare reassignment Care Compare group NPD
• Northwest Iowa Hospital Corporation

  • Emergency Medical Services (Emergency Medicine) Physician
  • Sioux City, IA
  • NPI 1215962550
  Medicare reassignment NPD

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527811200000",
    "number": "1922012293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840853",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840853",
            "telephone_number": "972-233-1999",
            "fax_number": "972-233-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 CITYWEST BLVD",
            "address_2": "STE. 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77042",
            "telephone_number": "713-620-4000",
            "fax_number": "713-458-4229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUCK",
        "first_name": "KELLY",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-29",
        "last_updated": "2018-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP114586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187247501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "85812U",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOUISIANA MEDICAID",
            "identifier": "1802484",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00355351",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "BERGMAN",
            "middle_name": "J",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Theresa Hatton, RN
• Ryann Hattori, CRNA
• Hatzalah of Houston
• Thomas Hau, M.D.
• Carol L Hauck, LCSW
• Jamie Hauerland
• Rusti T Hauge, M.D.
• Senona Marie Haugenater, LPC, ATR
• Kimberly Haughton
• Sonja Yvette Haughton, LPC

• Certified Registered Nurse Anesthetist in Houston, TX
• Providers in Houston, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.