DR. CHARLES JUSTIN HAGGERTY (NPI# 1487847430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487847430 |
| Entity Type | Individual |
| Full Name | DR. CHARLES JUSTIN HAGGERTY |
| Credential | M.D. |
| Practice Address |
2490 S Woodworth Loop Ste 200 Palmer AK 99645-7410 |
| Mailing Address |
Po Box 2610 Palmer AK 99645-2610 |
| Practice Telephone | 7087900201 |
| Mailing Telephone | 7087900201 |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2015-10-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | MEDS8124 | AK | Allopathic & Osteopathic Physicians |
| Street Address |
2490 S WOODWORTH LOOP STE 200 |
| City | PALMER |
| State | AK |
| Zip Code | 99645-7410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003874439 | Rodney S Badger | Internal Medicine | 2490 S Woodworth Loop Ste 200, Palmer, AK 99645-7410 | 2006-05-03 |
| 1548639727 | Pioneer Peak Orthopedics, LLC | Orthopaedic Surgery | 2490 S Woodworth Loop Ste 200, Palmer, AK 99645-7410 | 2015-09-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295357135 | Kasey M Flintoft | Occupational Therapist | 7200 E. Jim Cottrell Cir, Palmer, AK 99645 | 2020-05-14 |
| 1629601471 | Courtney Randol | Licensed Practical Nurse | 14405 E Pace Dr., Palmer, AK 99645 | 2020-02-20 |
| 1689213092 | Valerie Anne Delaune | Acupuncturist | 9693 N. Little Otter Dr., Palmer, AK 99645 | 2020-01-02 |
| 1003464512 | Alaskan Sunrise Behavioral Health, L.L.C. | Clinic/Center | 14460 E. Pace Dr., Palmer, AK 99645 | 2019-08-28 |
| 1548814718 | Maple Springs of Palmer Snf Holdings, LLC | Skilled Nursing Facility | 12130 E Maple Springs Way, Palmer, AK 99645 | 2019-07-26 |
| 1952868655 | Carla Beth Kelly | Physical Therapist | 7200 Jim Cottrell Circle, Palmer, AK 99645 | 2019-02-28 |
| 1366938375 | Wendy S Page | Behavior Technician | 7200 E Jim Cottrell, Wasilla, AK 99645 | 2018-07-03 |
| 1154845170 | Sarah Elizabeth Gilliland | Occupational Therapist | 7200 E Jim Cottrell Circle, Palmer, AK 99645 | 2017-08-01 |
| 1558885137 | Garland Brooks | Massage Therapist | 1934 Prospect Dr, Palmer, AK 99645 | 2017-07-26 |
| 1386165009 | Sommer Dawn Nielsen | Massage Therapist | 3566 N Mars Ave., Palmer, AK 99645 | 2017-07-03 |
| Find all providers in zip 99645 | ||||
| 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 |
|---|---|---|---|---|
| 1548639727 | Pioneer Peak Orthopedics, LLC | Orthopaedic Surgery | 2490 S Woodworth Loop Ste 200, Palmer, AK 99645-7410 | 2015-09-17 |
| 1912132614 | Michael Montano | Orthopaedic Surgery | 2490 S Woodworth Loop, Suite 200, Palmer, AK 99645-7410 | 2009-05-26 |
| 1366618530 | Curis Andrew Mina | Orthopaedic Surgery | 2490 South Woodworth Loop, Medical Plaza, Suite 350, Palmer, AK 99645 | 2008-05-07 |
| 1962583963 | Robert J Campbell | Orthopaedic Surgery | 40 Wright St, Palmer, MA 01069-1138 | 2006-10-17 |
| 1568573533 | Richard M Kane | Orthopaedic Surgery | 40 Wright St, Palmer, MA 01069-1138 | 2006-08-31 |
| 1093746596 | William Todd Pace | Orthopaedic Surgery | 2490 S. Woodworth Loop, Suite 350, Palmer, AK 99645-7411 | 2006-07-05 |
| 1245274133 | William Vaughn Gardner | Orthopaedic Surgery | 2490 S. Woodworth Loop, Suite 350, Palmer, AK 99645-7411 | 2006-06-15 |
| 1902840812 | Mark Eliot Clyde | Orthopaedic Surgery | 2490 S. Woodworth Loop, Ste 350, Palmer, AK 99645-7411 | 2006-06-15 |
| 1245284470 | Denali Orthopedic Surgery, P.C. | Orthopaedic Surgery | 2490 S Woodworth Loop, Suite 350, Palmer, AK 99645-7411 | 2006-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174051718 | Scott Innes Md PC | Orthopaedic Surgery | 240 Hospital Pl Ste 204, Soldotna, AK 99669-7559 | 2017-05-26 |
| 1265834782 | Surgical Specialists of Alaska LLC | Orthopaedic Surgery | 1690 W Pipestone Dr, Wasilla, AK 99654-9741 | 2014-09-17 |
| 1093057895 | Rabun Samuel Fox | Orthopaedic Surgery | 3831 Piper St Ste 220, Anchorage, AK 99508-4680 | 2013-03-20 |
| 1194987511 | Kevin Charles Paisley | Orthopaedic Surgery | 4015 Lake Otis Pkwy Ste 201, Anchorage, AK 99508-5235 | 2008-06-26 |
| 1447426424 | Andrew Lewis Cornelius | Orthopaedic Surgery | 673d Mdg, 5955 Zeamer Avenue, Jber, AK 99506 | 2008-04-30 |
| 1730394669 | Adam Covino Ellison | Orthopaedic Surgery | 1700 E Bogard Rd Ste 102, Wasilla, AK 99654-6563 | 2007-05-14 |
| 1568506657 | Marius Henry Panzarella | Orthopaedic Surgery | 1612 Mission Rd, Kodiak, AK 99615-6508 | 2007-02-20 |
| 1629132022 | John T Duddy | Orthopaedic Surgery | 2741 Debarr Rd Ste C305, Anchorage, AK 99508-2972 | 2006-12-20 |
| 1033278155 | Russell Degroote Md PC | Orthopaedic Surgery | 1621 Tongass Ave Ste 207, Ketchikan, AK 99901-6072 | 2006-12-06 |
| 1144392721 | Douglas Grant Smith | Orthopaedic Surgery | 4733 Pavalof St, Anchorage, AK 99507-1018 | 2006-11-15 |
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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.