James R Haeberlin, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

46990 Issued in MN

Practice address

615 S Mill St
Fergus Falls, MN 56537-2756

Phone

(218) 739-2221

Fax

(218) 739-5501

NPI assigned

Aug 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Firstcare Medical Foundation

  dba Samaritan Medical Clinics

  • Family Medicine Physician
  • Albany, OR
  • NPI 1740216498

  Surgery

  NPD (past)
• Good Samaritan Hospital Corvallis

  dba Samaritan Orthopedics-Luis Vela, DO

  • Durable Medical Equipment & Medical Supplies
  • Corvallis, OR
  • NPI 1477851186
  NPD (past)
• McKenzie Surgical Group PC

  • Surgery Physician
  • Springfield, OR
  • NPI 1144256314
  NPD (past)

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1982717567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 S MILL ST",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372756",
            "telephone_number": "218-739-2221",
            "fax_number": "218-739-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S MILL ST",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372756",
            "telephone_number": "218-739-2221",
            "fax_number": "218-739-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAEBERLIN",
        "first_name": "JAMES",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "46990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE NUMBER",
            "identifier": "1041963",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U-CARE NUMBER",
            "identifier": "132318",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "091256",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA NUMBER",
            "identifier": "3700042",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41091744413",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NUMBER",
            "identifier": "485T3HA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13656",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karoline Gustafson
• Julianne D Gutzmer, MD
• Nichole Lea Haack
• Elizabeth Lora-Noel Hacker, RN
• Corissa Lee Hackmann
• Carol Hagel, PHN
• Mary Hagstrom, RD, LD
• Tricia L Hahn, LPN
• Jennifer M Halberg, LADC
• Kelly Ann Halgerson, LPN

• Surgery Physician in Fergus Falls, MN
• Providers in Fergus Falls, MN by specialty
• Surgery Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.