BRUCE FREDRIC HAUPT (NPI# 1063581833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063581833 |
| Entity Type | Individual |
| Full Name | BRUCE FREDRIC HAUPT |
| Credential | MD |
| Practice Address |
610 Chestnut St South Charleston WV 25309 |
| Mailing Address |
4605 Maccorkle Ave Sw Ths Physician Partners, Inc. Administrative Office South Charleston WV 25309-1311 |
| Practice Telephone | 3047667515 |
| Practice Fax Number | 3047667566 |
| Mailing Telephone | 3044144800 |
| Mailing Fax Number | 3044144801 |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2018-07-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | 35-06-2182H | OH | Allopathic & Osteopathic Physicians |
| Y | 207X00000X | Orthopaedic Surgery | 18234 | WV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 0098202000 | 05 | |
| OH | RR MEDICARE | P00665593 | 01 |
| OH | OHIO MEDICAID - MOLINA | 2877347 | 01 |
| OH | OHIO MEDICAID - CARESOURCE | 310917085194 | 01 |
| WV | GROUP MEDICARE | B441 | 01 |
| OH | OH MEDIICAID UNISON | 000000258093 | 01 |
| OH | 2877347 | 05 | |
| WV | GROUP MEDICAID | 3810024049 | 01 |
| Street Address |
610 CHESTNUT ST |
| City | SOUTH CHARLESTON |
| State | WV |
| Zip Code | 25309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508868043 | David Leon Soulsby | Orthopaedic Surgery | 610 Chestnut St, South Charleston, WV 25309-1251 | 2005-08-15 |
| 1316579949 | Mary Rose Butcher | Physician Assistant | 610 Chestnut St, South Charleston, WV 25309-1251 | 2020-02-11 |
| 1942565239 | Seth Thomas Craft | Podiatrist | 610 Chestnut St, South Charleston, WV 25309-1251 | 2012-07-12 |
| 1538437629 | Justin Kiel Medlin | Physician Assistant | 610 Chestnut St, South Charleston, WV 25309-1251 | 2011-12-05 |
| 1104145135 | Freddie Dominick Persinger | Orthopaedic Surgery | 610 Chestnut St, South Charleston, WV 25309 | 2010-06-01 |
| 1649412578 | Matthew David Stover | Orthopaedic Surgery | 610 Chestnut St, South Charleston, WV 25309-1251 | 2009-03-24 |
| 1902968548 | Orthoclinic | Durable Medical Equipment & Medical Supplies | 610 Chestnut St, South Charleston, WV 25309-1251 | 2006-12-13 |
| 1114000825 | Orthoclinic | Specialist | 610 Chestnut St, South Charleston, WV 25309-1251 | 2006-10-24 |
| 1336116003 | Gary Lynn Johnson | Physician Assistant | 610 Chestnut St, South Charleston, WV 25309-1251 | 2006-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699376905 | Lovie Bradshaw | Technician | 4823 Tennessee St., South Charleston, WV 25309 | 2020-11-03 |
| 1306447735 | Barbara Mackenzie | Technician | 4224 Kanawha Turnpike, South Charleston, WV 25309 | 2020-11-03 |
| 1548861974 | Sarah Nichols | Technician | 4990 Colonial Park Dr. Apt. F, South Charleston, WV 25309 | 2020-11-03 |
| 1629690177 | Jennifer Mabry-goins | Technician | 4505 River Avenue, S Charleston, WV 25309 | 2020-05-07 |
| 1811537715 | Brandon C Dean | Psychologist | 4857 Macorkle Ave. Sw, South Charleston, WV 25309 | 2020-01-09 |
| 1467096057 | Linda Mullins | Technician | 60 Hayvon Lane, South Charleston, WV 25309 | 2019-11-06 |
| 1831743616 | Ann Myriah Beck | Nurse Practitioner | 4610 Maccorkle Ave Sw # 300, South Charleston, WV 25309 | 2019-07-30 |
| 1942671227 | Edward W Eskew | Family Medicine | 4605 Maccorkle Avenue, Sw, Thspp-psychiatry, South Charleston, WV 25309 | 2015-10-13 |
| 1720468218 | Link Investments LLC | Pharmacy | 5151 Macorkle Avenue, South Charleston, WV 25309 | 2015-06-01 |
| 1366840951 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 304 Southbridge Blvd., S.ccharleston, WV 25309 | 2014-12-12 |
| Find all providers in zip 25309 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548502354 | William David Mccormick | Orthopaedic Surgery | 60 Castle Pine Ln, South Charleston, WV 25309 | 2013-03-19 |
| 1316016603 | Joseph Edmund Fernandes | Orthopaedic Surgery | 401 Division St Ste 104, South Charleston, WV 25309-1455 | 2006-11-08 |
| 1932122512 | Phillip D Surface | Orthopaedic Surgery | 4607 Maccorkle Ave Sw Ste 401, South Charleston, WV 25309 | 2006-07-25 |
| 1508868043 | David Leon Soulsby | Orthopaedic Surgery | 610 Chestnut St, South Charleston, WV 25309-1251 | 2005-08-15 |
| 1104145135 | Freddie Dominick Persinger | Orthopaedic Surgery | 610 Chestnut St, South Charleston, WV 25309 | 2010-06-01 |
| 1649412578 | Matthew David Stover | Orthopaedic Surgery | 610 Chestnut St, South Charleston, WV 25309-1251 | 2009-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447760756 | First Settlement Orthopaedics Inc | Orthopaedic Surgery | 1600 Murdoch Ave Ste 100, Parkersburg, WV 26101-3248 | 2017-10-02 |
| 1003251851 | Dana S Lycans | Orthopaedic Surgery | 2211 3rd Ave, Huntington, WV 25703-1225 | 2013-05-07 |
| 1922392851 | Stonewall Jackson Memorial Hospital Company | Orthopaedic Surgery | 29 Hospital Plz Ste C, Weston, WV 26452-8471 | 2011-06-08 |
| 1730473026 | Integrated Health Care Providers, Inc. | Orthopaedic Surgery | 1399 Hospital Dr, Hurricane, WV 25526-8709 | 2011-06-03 |
| 1568695047 | Chad Harrison Poage | Orthopaedic Surgery | 47 Highland Ridge Rd, Bridgeport, WV 26330-9263 | 2009-08-31 |
| 1447489828 | William Mcneel Browning IIi | Orthopaedic Surgery | 3100 Maccorkle Seave 900, Charleston, WV 25304-1223 | 2009-07-07 |
| 1356540249 | Scott D Daffner | Orthopaedic Surgery | 1 Stadiumdrive, Morgantown, WV 26506 | 2007-07-12 |
| 1730390782 | Scott Roberts | Orthopaedic Surgery | 10 Mulligan Dr, Petersburg, WV 26847-1000 | 2007-05-24 |
| 1861618738 | Saghir Ur Rehman Mir | Orthopaedic Surgery | 401 6th Avenue, Suite 302, Montgomery, WV 25136 | 2007-04-18 |
| 1477673218 | Diane Elain Shafer | Orthopaedic Surgery | 114 W 2nd Ave # 749, 114 West Second Ave., Williamson, WV 25661-3104 | 2007-03-29 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH CHARLESTON |
| Zip Code | 25309 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.