Individual provider Active NPI

Justin David Haggard, D.C.

  • Chiropractor
  • Peoria, AZ
National Provider Identifier
1972675262
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5421 Issued in AZ
Practice address
8278 W Lake Pleasant Pkwy Ste 103
Peoria, AZ 85382-7441
Phone
(623) 322-1925
Fax
(201) 246-6678
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5421 AZ Primary

Addresses

Primary practice location

8278 W Lake Pleasant Pkwy Ste 103
Peoria, AZ 85382-7441

Mailing address

8278 W Lake Pleasant Pkwy Ste 103
Peoria, AZ 85382-7441
Phone (623) 322-1925

Other practice location 1

5115 N Dysart Rd Ste 212
Litchfield Park, AZ 85340-3052
Phone (623) 289-9350

Other identifiers 1

IdentifierTypeStateIssuer
AZ0934710OtherAZBCBS OF AZ PROVIDER NUM.

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1972675262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8278 W LAKE PLEASANT PKWY STE 103",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853827441",
            "telephone_number": "623-322-1925",
            "fax_number": "201-246-6678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8278 W LAKE PLEASANT PKWY STE 103",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853827441",
            "telephone_number": "623-322-1925",
            "fax_number": "201-246-6678"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5115 N Dysart Rd Ste 212",
            "address_purpose": "LOCATION",
            "city": "Litchfield Park",
            "state": "AZ",
            "postal_code": "853403052",
            "country_code": "US",
            "telephone_number": "623-289-9350",
            "fax_number": "201-246-6678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGGARD",
        "first_name": "JUSTIN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "5421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AZ PROVIDER NUM.",
            "identifier": "AZ0934710",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.