Active NPI
Clinton R Haggard, ATC, LAT, NREMT-B
- Basic Emergency Medical Technician
- Columbia, SC
National Provider Identifier
1962430546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Basic Emergency Medical Technician
- License
- 8362
- Practice address
- 1125 George Rogers Blvd
Columbia, SC 29208-0001 - Phone
- (803) 777-5574
- Fax
- (803) 777-8286
- NPI assigned
- Jun 30, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Basic Emergency Medical Technician | 146N00000X | 8362 | AL | Primary |
Addresses
Primary practice location
1125 George Rogers Blvd
Columbia, SC 29208-0001
Mailing address
1125 George Rogers Blvd
Columbia, SC 29208-0001
Phone (803) 777-5574
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8362 | AL | MD | Basic Emergency Medical Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460678400000",
"number": "1962430546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1125 GEORGE ROGERS BLVD",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292080001",
"telephone_number": "803-777-5574",
"fax_number": "803-777-8286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1125 GEORGE ROGERS BLVD",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292080001",
"telephone_number": "803-777-5574",
"fax_number": "803-777-8286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAGGARD",
"first_name": "CLINTON",
"middle_name": "R",
"name_prefix": "Mr.",
"credential": "ATC, LAT, NREMT-B",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-30",
"last_updated": "2016-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "146N00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Basic",
"state": "AL",
"license": "8362",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.