Active NPI
Glynnis J Haley, NP-C
- Family Nurse Practitioner
- Macon, GA
National Provider Identifier
1063585248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- RN115633
- Practice address
- 250 Martin Luther King Jr Blvd
Macon, GA 31201 - Phone
- (478) 301-4111
- Fax
- (478) 301-5812
- NPI assigned
- Nov 16, 2006
- Last updated
- Jul 17, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN115633 | GA | Primary |
Addresses
Primary practice location
250 Martin Luther King Jr Blvd
Macon, GA 31201
Mailing address
PO Box 4947
Macon, GA 31208-4947
Phone (478) 301-2362
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000934304C | Medicaid | GA | |
| 500025995 | Other | GA | RAILROAD MEDICARE |
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)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgia Cancer Specialists I, PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Specialist
- Atlanta, GA
- NPI 1821076241
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405555200000",
"number": "1063585248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4947",
"city": "MACON",
"state": "GA",
"postal_code": "312084947",
"telephone_number": "478-301-2362",
"fax_number": "478-301-2272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 MARTIN LUTHER KING JR BLVD",
"city": "MACON",
"state": "GA",
"postal_code": "31201",
"telephone_number": "478-301-4111",
"fax_number": "478-301-5812"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALEY",
"first_name": "GLYNNIS",
"middle_name": "J",
"credential": "NP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-16",
"last_updated": "2014-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "GA",
"license": "RN115633",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000934304C",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "500025995",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Macon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.