Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1952300923 Deactivated / Inactive NPI Male Practitioner

Dr. Clemens E. Haggerty , DO

General Practice • Iberia, MO

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Clemens Haggerty has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 20, 2005
NPI Deactivation Date January 02, 2025
Total Practice Duration ~20 Years of Practice (2005 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. Clemens Haggerty, DO was a registered General Practice practicing in Iberia, MO. Throughout an active medical career spanning 20 years, Dr. Haggerty provided care at the practice location at 2333 HIGHWAY 17 until profile deactivation on 2025-01-02.

Practice Location & Contact Primary Location

Practice Address

2333 Highway 17

Iberia, MO 654869331

Telephone 5737936900
Fax 5737936688
Associated Practice Facility / Clinic
🏢 Lake Regional Health System Facility NPI 1891018784

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Iberia, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 29.0 Yrs
Regional Practice Density
1 Specialists

Practicing in Iberia, MO (221 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License MO 30307

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
Margaret Hart , NP

Nurse Practitioner - Family

NPI 1104853050

Nurse Practitioner

Dr. Gary Thomsen , MD

Family Medicine

NPI 1164515029

Doctor of Medicine (M.D.)

Dr. Robert Mason , DO

Family Medicine

NPI 1821097718

Doctor of Osteopathic Medicine (D.O.)

Chelsie Deardeuff , FNP

Nurse Practitioner - Family

NPI 1841749660

Family Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated January 02, 2025

Record deactivated on January 02, 2025

NPI Profile Active December 06, 2012

NPI status registered as active in NPPES database

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Updated Practice Location December 06, 2012

Registered at 2333 HIGHWAY 17, IBERIA, MO 654869331 (Tel: 5737936900)

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Updated Business Mailing Address December 06, 2012

Registered at PO BOX 1500, OSAGE BEACH, MO 650651500

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Provider Name / Credentials Updated December 06, 2012

Recorded as CLEMENS HAGGERTY, D.O.

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 06, 2012

General Practice (License #30307 in MO)

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Initial NPI Registration & Enumeration July 20, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1952300923
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 20, 2005
Last Update: December 06, 2012
Deactivation Date: January 02, 2025

Mailing Address

Po Box 1500

Osage Beach, MO 650651500

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.