Traci Dawn Havens, R.T.

Primary specialty

Radiologic TechnologistTaxonomy code 247100000X

License

R2527984 Issued in OH

Practice address

2705 Virginia Ridge Rd
Philo, OH 43771-9761

Phone

(740) 455-1648

NPI assigned

Mar 10, 2010

Last updated

Mar 10, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1268179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268179200000",
    "number": "1962725507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 VIRGINIA RIDGE RD",
            "city": "PHILO",
            "state": "OH",
            "postal_code": "437719761",
            "telephone_number": "740-455-1648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 VIRGINIA RIDGE RD",
            "city": "PHILO",
            "state": "OH",
            "postal_code": "437719761",
            "telephone_number": "740-455-1648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVENS",
        "first_name": "TRACI",
        "middle_name": "DAWN",
        "name_prefix": "Ms.",
        "credential": "R.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-10",
        "last_updated": "2010-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "OH",
            "license": "R2527984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Radiologic Technologist in Philo, OH
• Providers in Philo, OH by specialty
• Radiologic Technologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2010; 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.