Individual provider Active NPI

Haley Alicia Egesdahl, PT, DPT

  • Physical Therapist
  • Ringgold, GA
National Provider Identifier
1144507864
Registry record updated Jun 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
010252 Issued in GA
Practice address
695 Castleview Dr
Ringgold, GA 30736-6907
Phone
(706) 616-3592
NPI assigned
Nov 9, 2011
Last updated
Jun 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 010252 GA Primary

Addresses

Primary practice location

695 Castleview Dr
Ringgold, GA 30736-6907

Mailing address

695 Castleview Dr
Ringgold, GA 30736-6907
Phone (706) 616-3592

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

State licenses

LicenseStateTypeSpecialty
010252GAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1320796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719014400000",
    "number": "1144507864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 CASTLEVIEW DR",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307366907",
            "telephone_number": "706-616-3592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 CASTLEVIEW DR",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307366907",
            "telephone_number": "706-616-3592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGESDAHL",
        "first_name": "HALEY",
        "middle_name": "ALICIA",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-09",
        "last_updated": "2024-06-22",
        "certification_date": "2024-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "010252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ringgold, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.