Active NPI
Jeffrey F Hines, MD
- Gynecologic Oncology Physician
- Austell, GA
National Provider Identifier
1093776056
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecologic Oncology Physician
- License
- 047443
- Practice address
- 1700 Hospital South Dr
Suite 102
Austell, GA 30106-6810 - Phone
- (770) 792-6262
- Fax
- (678) 398-1929
- NPI assigned
- Mar 30, 2006
- Last updated
- Apr 20, 2016
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Gynecologic Oncology Physician | 207VX0201X | 047443 | GA | Primary |
Addresses
Primary practice location
1700 Hospital South Dr
Suite 102
Austell, GA 30106-6810
Mailing address
1700 Hospital South Dr
Suite 102
Austell, GA 30106-6810
Phone (770) 792-6262
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000882714K | Medicaid | GA |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 047443 | GA | MD | Gynecologic Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeastern Gynecologic Oncology at Saint Joseph's, LLC | Gynecologic Oncology | Past | Accepting new patients |
| Ozarks Medical Center | Past | Accepting new patients |
Interoperability endpoints
- jhines39800@directwellstar.org
Organizations & group practices 2
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.
-
- Gynecologic Oncology Physician
- Atlanta, GA
- NPI 1750663118
-
dba Ozarks Healthcare
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461110400000",
"number": "1093776056",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 HOSPITAL SOUTH DR",
"address_2": "SUITE 102",
"city": "AUSTELL",
"state": "GA",
"postal_code": "301066810",
"telephone_number": "770-792-6262",
"fax_number": "678-398-1929"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 HOSPITAL SOUTH DR",
"address_2": "SUITE 102",
"city": "AUSTELL",
"state": "GA",
"postal_code": "301066810",
"telephone_number": "770-792-6262",
"fax_number": "678-398-1929"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HINES",
"first_name": "JEFFREY",
"middle_name": "F",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-30",
"last_updated": "2016-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "207VX0201X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecologic Oncology",
"state": "GA",
"license": "047443",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000882714K",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Austell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.