Individual provider Active NPI

Haley Dickey, PA

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1265972202
Registry record updated Mar 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-09207 Issued in NC
Practice address
4525 Cameron Valley Pkwy
Ste 1500
Charlotte, NC 28211-4369
Phone
(704) 512-6240
NPI assigned
Feb 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 0010-09207 NC Primary

Addresses

Primary practice location

4525 Cameron Valley Pkwy
Ste 1500
Charlotte, NC 28211-4369

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

5717 Albemarle Rd
Charlotte, NC 28212-1634
Phone (704) 563-2150

Other practice location 2

10210 Couloak Dr
Ste E
Charlotte, NC 28216-7679
Phone (704) 801-2000

Other practice location 3

5727 Prosperity Crossing Dr
Ste 1100
Charlotte, NC 28269-2206
Phone (704) 863-9930

Other practice location 4

7810 Providence Rd
Ste 102
Charlotte, NC 28226-2954
Phone (704) 543-6636

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network
Direct Messaging Address hbremkamp412052@CarolinasHealthcareSystem.direct-ci.com Atrium Health

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170831002623 CA Practitioner - Physician Assistant 8224301973 Reassigns benefits to 1 organization
I20191029003642 NC Practitioner - Physician Assistant 8224301973 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

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
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Oct 7, 2019 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 7, 2019 Accepting new patients

Locations

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

5727 Prosperity Crossing Dr
Ste 1100
Charlotte, NC 28269
Phone (704) 863-9930

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

10210 Couloak Dr
Ste E
Charlotte, NC 28216
Phone (704) 801-2000

5717 Albemarle Rd
Charlotte, NC 28212
Phone (704) 563-2150

7810 Providence Rd
Ste 102
Charlotte, NC 28226
Phone (704) 393-4808

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

4525 Cameron Valley Pkwy
Ste 1500
Charlotte, NC 28211
Phone (704) 512-6240

9332 S Tryon St
Charlotte, NC 28273
Phone (704) 587-6700

4525 Cameron Valley Pkwy
Ste 4100D
Charlotte, NC 28211
Phone (704) 801-7310

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

Interoperability endpoints

  • Direct secure messaging: hbremkamp412052@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 6

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": "1487808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1265972202",
    "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": "4525 CAMERON VALLEY PKWY",
            "address_2": "STE 1500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282114369",
            "telephone_number": "704-512-6240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5717 Albemarle Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282121634",
            "country_code": "US",
            "telephone_number": "704-563-2150",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10210 Couloak Dr",
            "address_2": "Ste E",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282167679",
            "country_code": "US",
            "telephone_number": "704-801-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5727 Prosperity Crossing Dr",
            "address_2": "Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282692206",
            "country_code": "US",
            "telephone_number": "704-863-9930",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7810 Providence Rd",
            "address_2": "Ste 102",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282262954",
            "country_code": "US",
            "telephone_number": "704-543-6636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKEY",
        "first_name": "HALEY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-23",
        "last_updated": "2022-03-22",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-09207",
            "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": "hbremkamp412052@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "4525 Cameron Valley Pkwy",
            "address_2": "Ste 1500",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282114369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.