Individual provider Active NPI

Heather B. Haley, CNM

  • Advanced Practice Midwife
  • Vidalia, GA
National Provider Identifier
1134624455
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
Practice address
101 Harris Industrial Blvd Ste C
Vidalia, GA 30474-8852
Phone
(912) 537-1014
Fax
(912) 538-1538
NPI assigned
Mar 28, 2018
Last updated
Apr 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X Primary
Family Nurse Practitioner 363LF0000X RN217338 GA

Addresses

Primary practice location

101 Harris Industrial Blvd Ste C
Vidalia, GA 30474-8852

Mailing address

101 Harris Industrial Blvd Ste C
Vidalia, GA 30474-8852
Phone (912) 537-1014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20180820002007 GA Practitioner - Nurse Practitioner 2961751235 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Houston Physician Specialists, LLC. CurrentSince Feb 1, 2023 Accepting new patients
Houston Physician Specialists, LLC CurrentSince Feb 1, 2023 Accepting new patients
Associates in Obstetrics & Gynecology, PC CurrentSince Apr 27, 2025 Accepting new patients

Locations

105 Jw Plaza Dr SE
Ste 1
Calhoun, GA 30701
Phone (706) 278-4640

1105 Burleyson Rd
Dalton, GA 30720
Phone (706) 278-4640

1021 N Houston Rd
Warner Robins, GA 31093
Phone (478) 922-9944

233 N Houston Rd
Ste 171
Warner Robins, GA 31093
Phone (478) 352-7050

Interoperability endpoints

  • Direct secure messaging: heather.haley.1@4044.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/4044/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1134624455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HARRIS INDUSTRIAL BLVD STE C",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748852",
            "telephone_number": "912-537-1014",
            "fax_number": "912-538-1538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HARRIS INDUSTRIAL BLVD STE C",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748852",
            "telephone_number": "912-537-1014",
            "fax_number": "912-538-1538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALEY",
        "first_name": "HEATHER",
        "middle_name": "B.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-28",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN217338",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vidalia, GA

Sources for this page

Verify at the official NPI Registry.