Havens Family Clinic

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

2124 Issued in CO

Legal business name

HAVENS FAMILY CLINIC

Practice address

109 Latigo LN
Suite C
Canon City, CO 81212-8112

Phone

(719) 276-3211

Fax

(719) 276-3011

NPI assigned

Feb 28, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Jason Morgan, PA CNPI 1831176924

Title

Owner

Phone

(719) 276-3211

Specialties & licenses 3

Addresses

Other identifiers 3

Practitioners 1

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

• Jason Richard Morgan, PAC

  • Physician Assistant
  • Stilwell, OK
  • NPI 1831176924

  Medical

  NPD Authorized official

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289520000000",
    "number": "1982731535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 LATIGO LN",
            "address_2": "SUITE C",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812128112",
            "telephone_number": "719-276-3211",
            "fax_number": "719-276-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 LATIGO LN",
            "address_2": "SUITE C",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812128112",
            "telephone_number": "719-276-3211",
            "fax_number": "719-276-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVENS FAMILY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2010-11-12",
        "status": "A",
        "authorized_official_last_name": "MORGAN",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-276-3211",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "28791",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "2124",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "NP4805",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI PROVIDER #",
            "identifier": "1205816949",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI PROVIDER #",
            "identifier": "1831176924",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74402374",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marci Lauree Harrison
• Anita Harvey
• Brent Alan Haskell, D.O.
• Havens Family Clinic
• Havens Family Clinic
• Amanda Hay, LCSW
• Health Seekers Enterprises PLLC
• Health Solutions Family Practice and Walk-in Clinic
• Hearts Made Happy, LLC
• John Sloan Heavrin I, M.D.

• Medical Physician Assistant in Canon City, CO
• Providers in Canon City, CO by specialty
• Medical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.