Individual provider Active NPI

Elisa Jane Haley, MD

  • Family Medicine Physician
  • Huntsville, AL
National Provider Identifier
1114092830
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD.27081 Issued in AL
Practice address
4800 Whitesport Cir SW Ste 1
#201
Huntsville, AL 35801-6444
Phone
(256) 327-0888
Fax
(256) 327-0891
NPI assigned
Nov 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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 MD.27081 AL Primary

Addresses

Primary practice location

4800 Whitesport Cir SW Ste 1
#201
Huntsville, AL 35801-6444

Mailing address

4800 Whitesport Cir SW Ste 1
Huntsville, AL 35801-6443
Phone (256) 327-0888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070830000003 AL Practitioner - Family Practice 8527151000 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2876 Bob Wallace Ave SW
Huntsville, AL 35805-4016
Phone (256) 327-0888

Hospital & facility affiliations

  • Huntsville Hospital Hospital, Huntsville, AL, CCN 010039
  • Crestwood Medical Center Hospital, Huntsville, AL, CCN 010131
  • Athens Limestone Hospital Hospital, Athens, AL, CCN 010079

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.27081ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elisa J Haley MD PC Family Medicine CurrentSince Dec 1, 2008 Accepting new patients

Locations

4800 Whitesport Cir SW
Ste 1
Huntsville, AL 35801
Phone (256) 327-0888

2876 Bob Wallace Ave SW
Huntsville, AL 35805
Phone (256) 327-0888

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1114092830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 WHITESPORT CIR SW STE 1",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016443",
            "telephone_number": "256-327-0888",
            "fax_number": "256-327-0891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 WHITESPORT CIR SW STE 1",
            "address_2": "#201",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016444",
            "telephone_number": "256-327-0888",
            "fax_number": "256-327-0891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALEY",
        "first_name": "ELISA",
        "middle_name": "JANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "MD.27081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.