Individual provider Active NPI

Garry Hart Hailey II

  • Clinical Social Worker
  • Durham, NC
National Provider Identifier
1063148146
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P017665 Issued in NC
Practice address
2530 Meridian Pkwy Ste 300
Durham, NC 27713-5273
Phone
(919) 443-1708
NPI assigned
Jul 29, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X P017665 NC Primary

Addresses

Primary practice location

2530 Meridian Pkwy Ste 300
Durham, NC 27713-5273

Mailing address

2530 Meridian Pkwy Ste 300
Durham, NC 27713-5273

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL securerecords.sanford.html

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P017665NCMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1659052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1063148146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 MERIDIAN PKWY STE 300",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277135273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 MERIDIAN PKWY STE 300",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277135273",
            "telephone_number": "919-443-1708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAILEY",
        "first_name": "GARRY",
        "middle_name": "HART",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-29",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P017665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "securerecords.sanford.html",
            "affiliation": "N",
            "address_1": "2530 Meridian Pkwy Ste 300",
            "city": "Durham",
            "state": "NC",
            "country_code": "US",
            "postal_code": "277135273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.