Thomas Patrick Haverty, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

25MA05678500 Issued in NJ

Practice address

2015 Galloping Hill Rd
Kenilworth, NJ 07033-1310

Phone

(908) 740-3800

Fax

(908) 740-5002

NPI assigned

Apr 13, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Thomas Patrick Haverty Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1239580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239580800000",
    "number": "1922241546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 GALLOPING HILL RD",
            "city": "KENILWORTH",
            "state": "NJ",
            "postal_code": "070331310",
            "telephone_number": "908-740-3800",
            "fax_number": "908-740-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 GALLOPING HILL RD",
            "city": "KENILWORTH",
            "state": "NJ",
            "postal_code": "070331310",
            "telephone_number": "908-740-3800",
            "fax_number": "908-740-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVERTY",
        "first_name": "THOMAS",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-13",
        "last_updated": "2009-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MA05678500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THOMAS",
            "last_name": "HAVERTY",
            "middle_name": "PATRICK",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Nephrology Physician in Kenilworth, NJ
• Providers in Kenilworth, NJ by specialty
• Nephrology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2009; 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.