Haley E Douglas, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4380 Issued in TN

Practice address

907 E Lamar Alexander Pkwy
Maryville, TN 37804-5015

Phone

(865) 977-5534

Fax

(865) 981-2154

NPI assigned

Jan 19, 2021

Last updated

Oct 27, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Spring Hill, TN
  • NPI 1134452865
  Medicare reassignment NPD
• Blount Memorial Physician Group, Inc

  • Family Medicine Physician
  • Alcoa, TN
  • NPI 1699710194
  Medicare reassignment
• US Diabetes Care and Surgical Specialty of Morristown TN

  • Family Medicine Physician
  • Morristown, TN
  • NPI 1427610211
  Medicare reassignment
• US Diabetes Care of Morristown, LLC

  • Clinic/Center
  • Morristown, TN
  • NPI 1255995916
  Medicare reassignment
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Chapel Hill, TN
  • NPI 1316602774
  NPD
• Harrogate Family Practice

  • Nurse Practitioner
  • Harrogate, TN
  • NPI 1417119595
  NPD (past)

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

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1093305583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 E LAMAR ALEXANDER PKWY",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045015",
            "telephone_number": "865-977-5534",
            "fax_number": "865-981-2154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "HALEY",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-19",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "4380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q071790",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donald Earl Walker (Village Pharmacy)
• Donna K Rule
• Morgan Donnell
• Kevin Michael Donovan, M.D.
• Erika Lena Dorfi
• Scott McMahon Douglas, DPT
• Daniel J Dovgan, MD
• Shannon O Dow
• Dr Michael T Kolarik OD
• Dr. Mary Conway & Associates LLC

• Physician Assistant in Maryville, TN
• Providers in Maryville, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.