Individual provider Active NPI

Dayle C Hawthorne, M.D.

  • Family Medicine Physician
  • Fort Oglethorpe, GA
National Provider Identifier
1235234592
Registry record updated Apr 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22237 Issued in GA
Practice address
1384 Battlefield Pkwy
Fort Oglethorpe, GA 30742-4010
Phone
(706) 861-2700
Fax
(706) 861-2745
NPI assigned
Sep 13, 2006
Last updated
Apr 11, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2012

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 22237 GA Primary

Addresses

Primary practice location

1384 Battlefield Pkwy
Fort Oglethorpe, GA 30742-4010

Mailing address

1384 Battlefield Pkwy
Fort Oglethorpe, GA 30742-4010
Phone (706) 861-2700

Other names 1

  • Dayle C Berry Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120417000481 GA Practitioner - Family Practice 0042471674 Reassigns benefits to 1 organization
I20190205001527 FL Practitioner - Family Practice 0042471674 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Howard University College of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Afc Florida, LLCGroup PAC ID 2769616762, 22 clinicians

Practice addresses (Care Compare)

4713 Hwy 90
Pace, FL 32571-1403
Phone (850) 304-0694

Merit-based Incentive Payment System (MIPS)

Final score
71.83 of 100Reported as group
Quality
61.85
Improvement activities
40
Cost
76.05

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22237GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Afc Florida, LLC Family Medicine CurrentSince Dec 26, 2018 Accepting new patients
C & C Medical Group, Inc. CurrentSince Jun 10, 1999 Accepting new patients

Locations

3700 Cahaba Beach Rd
Hoover, AL 35242
Phone (205) 403-8902

4713 Highway 90
Pace, FL 32571
Phone (850) 304-0694

15415 Panama City Beach Pkwy
Panama City Beach, FL 32413
Phone (850) 588-3589

1384 Battlefield Pkwy
Ft Oglethorpe, GA 30742
Phone (706) 858-8083

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, 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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334102400000",
    "number": "1235234592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1384 BATTLEFIELD PKWY",
            "city": "FORT OGLETHORPE",
            "state": "GA",
            "postal_code": "307424010",
            "telephone_number": "706-861-2700",
            "fax_number": "706-861-2745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1384 BATTLEFIELD PKWY",
            "city": "FORT OGLETHORPE",
            "state": "GA",
            "postal_code": "307424010",
            "telephone_number": "706-861-2700",
            "fax_number": "706-861-2745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWTHORNE",
        "first_name": "DAYLE",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2012-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "22237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAYLE",
            "last_name": "BERRY",
            "middle_name": "C",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Oglethorpe, GA

Sources for this page

Verify at the official NPI Registry.