Michael S Haverty MD Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G53646 Issued in CA

Legal business name

MICHAEL S HAVERTY MD INC

Practice address

2342 Professional Pkwy
Suite 260
Santa Maria, CA 93455-1629

Phone

(805) 348-3950

Fax

(805) 348-9301

NPI assigned

Feb 16, 2007

Organization subpart

No

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

Authorized official

Name

Michael S Haverty, MDNPI 1235114729

Title

Owner

Phone

(805) 348-3910

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael S Haverty, MD

  • Family Medicine Physician
  • Santa Maria, CA
  • NPI 1235114729
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393891200000",
    "number": "1952445595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2342 PROFESSIONAL PKWY",
            "address_2": "SUITE 260",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934551629",
            "telephone_number": "805-348-3950",
            "fax_number": "805-348-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2342 PROFESSIONAL PKWY",
            "address_2": "SUITE 260",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934551629",
            "telephone_number": "805-348-3950",
            "fax_number": "805-348-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL S HAVERTY MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2014-03-04",
        "status": "A",
        "authorized_official_last_name": "HAVERTY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-348-3910",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G53646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.