Active NPI
William O Haug Jr., M.D.
- Sports Medicine (Family Medicine) Physician
- Cloquet, MN
National Provider Identifier
1922084284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Family Medicine) Physician
- License
- 10460
- Practice address
- 512 Skyline Blvd
Cloquet, MN 55720-1199 - Phone
- (218) 879-4641
- NPI assigned
- Dec 19, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 46850-020 | WI | |
| Family Medicine Physician | 207Q00000X | 42654 | MN | |
| Family Medicine Physician | 207Q00000X | 5007 | AK | |
| Sports Medicine (Family Medicine) Physician | 207QS0010X | 10756 | MT | |
| Sports Medicine (Family Medicine) Physician | 207QS0010X | 10460 | ND | Primary |
Addresses
Primary practice location
512 Skyline Blvd
Cloquet, MN 55720-1199
Mailing address
512 Skyline Blvd
Cloquet, MN 55720-1199
Phone (218) 879-4641
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0147339 | Medicaid | MT |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | hisdept@direct.cloquethospital.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of North Dakota School of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
512 Skyline Blvd
Cloquet, MN 55720-3787
Phone (218) 879-4641
Hospital & facility affiliations
- Community Memorial Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5007 | AK | MD | Family Medicine Physician |
| 46850-020 | WI | MD | Family Medicine Physician |
| 10756 | MT | MD | Sports Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Memorial Hospital Association | Current | Accepting new patients |
Locations
512 Skyline Blvd
Cloquet, MN 55720
Phone (218) 878-7207
Interoperability endpoints
- hisdept@direct.cloquethospital.com
Organizations & group practices 1
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.
-
- Critical Access Hospital
- Cloquet, MN
- NPI 1003869082
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Cloquet, MN
- NPI 1003869082
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606780800000",
"number": "1922084284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "512 SKYLINE BLVD",
"city": "CLOQUET",
"state": "MN",
"postal_code": "557201199",
"telephone_number": "218-879-4641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "512 SKYLINE BLVD",
"city": "CLOQUET",
"state": "MN",
"postal_code": "557201199",
"telephone_number": "218-879-4641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAUG",
"first_name": "WILLIAM",
"middle_name": "O",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-19",
"last_updated": "2020-12-01",
"certification_date": "2020-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "46850-020",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "42654",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AK",
"license": "5007",
"primary": false
},
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "MT",
"license": "10756",
"primary": false
},
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "ND",
"license": "10460",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0147339",
"state": "MT"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "hisdept@direct.cloquethospital.com",
"affiliation": "N",
"address_1": "512 Skyline Blvd",
"city": "Cloquet",
"state": "MN",
"country_code": "US",
"postal_code": "557201199",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Cloquet, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.