Individual provider Active NPI

Jennifer Brooke Hale, MD

  • Surgery Physician
  • Concord, NC
National Provider Identifier
1194041434
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2015-00751 Issued in NC
Practice address
920 Church St N
Concord, NC 28025-2927
Phone
(704) 403-1311
NPI assigned
Apr 12, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X 2015-00751 NC
Surgery Physician 208600000X 2015-00751 NC Primary

Addresses

Primary practice location

920 Church St N
Concord, NC 28025-2927

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

101 E W T Harris Blvd
Bldg 5000, Suite #5101
Charlotte, NC 28262-3485
Phone (704) 863-5847

Other practice location 2

500 Lauchwood Dr
Laurinburg, NC 28352-5501
Phone (910) 291-6904

Other practice location 3

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 446-4490

Other practice location 4

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 446-1255

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network
Direct Messaging Address jhale136869@CarolinasHealthcareSystem.direct-ci.com Atrium Health

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20160204001580 NC Practitioner - General Surgery 4385948769 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Brody School of Medicine at East Carolina University, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

14214 Ballantyne Lake Rd
Charlotte, NC 28277-3373

920 Church St N
Concord, NC 28025-2927
Phone (704) 403-1331

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2015-00751NCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc Surgery CurrentSince Mar 20, 2017 Accepting new patients
Carolinas Medical Center Current Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Dec 1, 2016 Accepting new patients
Carolinas Medical Center Surgery CurrentSince Dec 21, 2015 Accepting new patients
Carolinas Pathology Group, PA Current Accepting new patients
Carolinas Medical Center CurrentSince Dec 21, 2015 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Dec 1, 2016 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Mar 20, 2017 Accepting new patients
Carolinas Medical Center Surgical Critical Care Past Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

920 Church St N
Ste 255
Concord, NC 28025
Phone (704) 403-1331

1085 NE Gateway Ct NE
#200A
Concord, NC 28025
Phone (704) 403-8650

920 Church St N
Concord, NC 28025
Phone (704) 403-3000

200 Medical Park Dr
Ste 250
Concord, NC 28025
Phone (704) 403-2740

500 Lauchwood Dr
Laurinburg, NC 28352
Phone (856) 848-3227

Interoperability endpoints

  • Direct secure messaging: jhale136869@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 12

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 2

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": "1271030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1194041434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 CHURCH ST N",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252927",
            "telephone_number": "704-403-1311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 E W T Harris Blvd",
            "address_2": "Bldg 5000, Suite #5101",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282623485",
            "country_code": "US",
            "telephone_number": "704-863-5847",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Lauchwood Dr",
            "address_purpose": "LOCATION",
            "city": "Laurinburg",
            "state": "NC",
            "postal_code": "283525501",
            "country_code": "US",
            "telephone_number": "910-291-6904",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 S Kings Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282072134",
            "country_code": "US",
            "telephone_number": "704-446-4490",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 S Kings Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282072134",
            "country_code": "US",
            "telephone_number": "704-446-1255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALE",
        "first_name": "JENNIFER",
        "middle_name": "BROOKE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-12",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NC",
            "license": "2015-00751",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2015-00751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhale136869@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "920 Church St N",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280252927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.