CAYLON W. HAGGARD (NPI# 1902042765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902042765 |
| Entity Type | Individual |
| Full Name | CAYLON W. HAGGARD |
| Credential | PA-C |
| Practice Address |
411 Fortuyn Rd Grand Coulee WA 99133-8718 |
| Practice Telephone | 5096331911 |
| Practice Fax Number | 5096331933 |
| Mailing Telephone | 5096331911 |
| Mailing Fax Number | 5096331933 |
| Enumeration Date | 2008-12-29 |
| Last Update Date | 2020-06-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 1787 | OK | Allopathic & Osteopathic Physicians |
| Y | 363A00000X | Physician Assistant | PA61041209 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 1787 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 2155035 | 05 | |
| OK | 200234370A | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1000 Kingfisher Regional Hospital Drive, Kingfisher, OK 737505002 | 4053757847 | |
| 14321 Ne 23rd St, Choctaw, OK 730208624 | 4053420255 | 4056106960 |
| Street Address |
411 FORTUYN RD |
| City | GRAND COULEE |
| State | WA |
| Zip Code | 99133-8718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205838703 | David Martin Brown | Nurse Anesthetist, Certified Registered | 411 Fortuyn Rd, Coulee Community Hospital, Grand Coulee, WA 99133-8718 | 2005-08-15 |
| 1144725664 | Amy Anne Haden | Registered Nurse | 411 Fortuyn Rd, Grand Coulee, WA 99133-8718 | 2018-03-27 |
| 1639689748 | Cheney Owl Pharmacy Inc | Pharmacy | 411 Fortuyn Rd, Grand Coulee, WA 99133-8718 | 2017-10-03 |
| 1982050779 | Leah G Kobes | Family Medicine | 411 Fortuyn Rd, Grand Coulee, WA 99133-8718 | 2016-05-11 |
| 1003274614 | Anna Hardesty | Physical Therapist | 411 Fortuyn Rd, Grand Coulee, WA 99133-8718 | 2016-02-10 |
| 1740653807 | Kathleen Christine Henry | Physician Assistant | 411 Fortuyn Rd, Grand Coulee, WA 99133-8718 | 2015-11-10 |
| 1255709614 | Melissa Stanley | Registered Nurse | 411 Fortuyn Rd, Grand Coulee, WA 99133-8718 | 2015-09-02 |
| 1134516933 | Jennifer Knox | Family Medicine | 411 Fortuyn Rd, Grand Coulee, WA 99133-8718 | 2015-04-20 |
| 1780080515 | Jacie L Van Blaricom | Dietitian, Registered | 411 Fortuyn Rd, Grand Coulee, WA 99133-8718 | 2014-11-05 |
| 1538589023 | Marilynn Holman | Psychiatry & Neurology | 411 Fortuyn Rd, Grand Coulee, WA 99133-8718 | 2014-04-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134754468 | Alexander Chhun Tor | Pharmacist | 320 Midway Ave., Grand Coulee, WA 99133 | 2020-03-06 |
| 1093081333 | Cara Turner | Pharmacist | 320 Midway Avenue, Grand Coulee, WA 99133 | 2012-03-30 |
| 1922312479 | Elizabeth Hsu | Internal Medicine | 411 Fortuyn Road, Grand Coulee, WA 99133 | 2010-07-27 |
| 1295909448 | Jg Pepperd Dc Pllc | Chiropractor | 400 Burdin Blvd, Grand Coulee, WA 99133 | 2008-04-18 |
| 1629171616 | Galen Neal Schmidt | Optometrist | 407 Burdin Blvd., Grand Coulee, WA 99133 | 2006-09-06 |
| 1841230489 | Lesa Eiffert | Counselor | 322 Fortuyn Rd, Grand Coulee, WA 99133 | 2006-06-08 |
| 1578919700 | Real Vision, Inc | Optometrist | 407 Burdin Blvd, Grand Coulee, WA 99133 | 2016-05-06 |
| 1255770020 | Kyle M. Gillespie, O.d., Ltd. | Optometrist | 407 Burdin Blvd, Grand Coulee, WA 99133 | 2013-06-14 |
| 1568716975 | Kai Scott | Physical Therapist | 321 Burdin Boulevard, Grand Coulee, WA 99133 | 2012-11-07 |
| 1972657328 | Kelly J Prather | Physical Therapist | 321 Burdin Blvd, Grand Coulee Physical Therapy, Grand Coulee, WA 99133 | 2007-01-23 |
| Find all providers in zip 99133 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740653807 | Kathleen Christine Henry | Physician Assistant | 411 Fortuyn Rd, Grand Coulee, WA 99133-8718 | 2015-11-10 |
| 1639451750 | Samantha B Brunner | Physician Assistant | 411 Fortuyn Rd, Grand Coulee, WA 99133-8718 | 2011-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831790591 | Bailey Mantha-nagrant | Physician Assistant | 7912 170th Ave Ne Unit 301, Redmond, WA 98052-0907 | 2020-11-07 |
| 1518567791 | Addison Christine Richert | Physician Assistant | 121 Kingfisher Pl, Port Hadlock, WA 98339-8733 | 2020-10-28 |
| 1992312177 | Robert Monsees | Physician Assistant | 490 Packwood Ln, Ellensburg, WA 98926-8027 | 2020-09-30 |
| 1649887548 | Jesse E Davis | Physician Assistant | 3512 Serene Way, Lynnwood, WA 98087-5202 | 2020-09-25 |
| 1558977066 | Kimberly Ho | Physician Assistant | 23004 88th Ave W, Edmonds, WA 98026-8616 | 2020-09-20 |
| 1770198954 | Ashish Chaudhary | Physician Assistant | 1215 Dexter Ave N Apt 704, Seattle, WA 98109-3567 | 2020-09-14 |
| 1144835422 | Juleeann Stocking | Physician Assistant | 1517 17th Ave S, Seattle, WA 98144-3522 | 2020-09-13 |
| 1891309555 | Andrew Allyn Bloom | Physician Assistant | 5889 Bow St, Bow, WA 98232-8620 | 2020-09-01 |
| 1558973909 | Margaret Webster | Physician Assistant | 6501 36th Ave Nw, Seattle, WA 98117-6010 | 2020-08-18 |
| 1033720495 | Riley Richardson | Physician Assistant | 1008 E Windemere Ct, Spokane, WA 99223-6228 | 2020-08-11 |
| Find all providers with the same taxonomy | ||||
| City | GRAND COULEE |
| Zip Code | 99133 |
Please comment or provide details below to improve the information on CAYLON W. HAGGARD.
| 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.