NPIMap

Individual provider Active NPI

John W Hale Jr., M.D.

  • Family Medicine Physician
  • Union City, TN
National Provider Identifier
1104806413
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19519 Issued in TN
Practice address
1412 E Reelfoot Ave
Union City, TN 38261-5813
Phone
(731) 885-5131
Fax
(731) 885-5335
NPI assigned
Jan 20, 2006
Last updated
Jun 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 19519 TN Primary

Addresses

Primary practice location

1412 E Reelfoot Ave
Union City, TN 38261-5813

Mailing address

965 Ridge Lake Blvd Ste 103
Memphis, TN 38120-9446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100701000356 TN Practitioner - Family Practice 7416088646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
East Tennessee State University Quillen College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1412 E Reelfoot Ave
Union City, TN 38261-5813
Phone (731) 885-5131

36 Capital Way
Suite E
Atoka, TN 38004-7986
Phone (901) 837-6801

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.87 of 100Reported as group
Quality
64.75
Promoting interoperability
100
Improvement activities
40
Cost
74.81

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision21
Removal of skin lesions19
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
19519TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Memorial Medical Group Inc Family Medicine CurrentSince Feb 1, 2012 Accepting new patients
Baptist Memorial Medical Group Inc CurrentSince Feb 1, 2012 Accepting new patients
Union City Nursing and Rehabilitation Center LLC Past Accepting new patients
Turner Healthcare, Inc. Past Accepting new patients

Locations

36 Capital Way
Ste E
Atoka, TN 38004
Phone (901) 837-6801

7205 Wolf River Blvd
Ste 100
Memphis, TN 38138
Phone (901) 507-9466

8970 Winchester Rd
Memphis, TN 38125
Phone (901) 794-5806

965 Ridge Lake Blvd
Ste 103
Memphis, TN 38120
Phone (901) 227-3221

1020 E Reelfoot Ave
Union City, TN 38261
Phone (731) 885-5131

1412 E Reelfoot Ave
Union City, TN 38261
Phone (731) 885-5131

Interoperability endpoints

  • Direct secure messaging: jhale4598@direct.bmhcc.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Union City Health and RehabilitationUnion City, TN, CCN 445381 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2025
Jan 1, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1104806413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 103",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209446",
            "fax_number": "901-227-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 E REELFOOT AVE",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382615813",
            "telephone_number": "731-885-5131",
            "fax_number": "731-885-5335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALE",
        "first_name": "JOHN",
        "middle_name": "W",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "19519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, TN

Sources for this page

Verify at the official NPI Registry.