Active NPI
Sally Haley, MD
- General Practice Physician
- Brunswick, ME
National Provider Identifier
1053338855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 013740
- Practice address
- 93 Church Rd
Brunswick, ME 04011-7306 - Phone
- (207) 798-5907
- Fax
- (207) 729-5757
- NPI assigned
- Jul 16, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 013740 | ME | Primary |
Addresses
Primary practice location
93 Church Rd
Brunswick, ME 04011-7306
Mailing address
93 Church Rd
Brunswick, ME 04011-7306
Phone (207) 798-5907
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 013740 | Other | ME | MEDICAL LICENSE |
| 025883 | Other | ME | ANTHEM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Sep 30, 2016 through Sep 30, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053338855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "93 CHURCH RD",
"city": "BRUNSWICK",
"state": "ME",
"postal_code": "040117306",
"telephone_number": "207-798-5907",
"fax_number": "207-729-5757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "93 CHURCH RD",
"city": "BRUNSWICK",
"state": "ME",
"postal_code": "040117306",
"telephone_number": "207-798-5907",
"fax_number": "207-729-5757"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALEY",
"first_name": "SALLY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "ME",
"license": "013740",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "013740",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "025883",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brunswick, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.