Individual provider Active NPI

Michael Andrew Hale, M.D.

  • Pediatrics Physician
  • Dalton, GA
National Provider Identifier
1194736173
Registry record updated May 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
054571 Issued in GA
Practice address
2918 E Walnut Ave
Dalton, GA 30721-8738
Phone
(706) 529-4600
Fax
(706) 529-7625
NPI assigned
Aug 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 054571 GA Primary

Addresses

Primary practice location

2918 E Walnut Ave
Dalton, GA 30721-8738

Mailing address

2918 E Walnut Ave
Dalton, GA 30721-8738
Phone (706) 529-4600

Other identifiers 1

IdentifierTypeStateIssuer
495876434AMedicaidGA

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
054571GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bright Pediatrics, PC Pediatrics PastSince Jun 11, 2023 Accepting new patients
Hamilton Medical Center, Inc. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557273600000",
    "number": "1194736173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2918 E WALNUT AVE",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307218738",
            "telephone_number": "706-529-4600",
            "fax_number": "706-529-7625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2918 E WALNUT AVE",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307218738",
            "telephone_number": "706-529-4600",
            "fax_number": "706-529-7625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALE",
        "first_name": "MICHAEL",
        "middle_name": "ANDREW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2019-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "054571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "495876434A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2019; 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.