Kelly Ann Hale, D.O

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

00000000000000000000 Issued in OH

Practice address

240 Hospital Dr NE
Bolivia, NC 28422-8346

Phone

(910) 721-1700

NPI assigned

Mar 1, 2013

Last updated

Dec 4, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kelly Ann Miller Former name

Medicare fee-for-service enrollment

Enrolled in OH, NC2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
• FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10052317

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.

• Brunswick Community Hospital, LLC

  dba Novant Health Brunswick Medical Center CRNAS

  • Certified Registered Nurse Anesthetist
  • Bolivia, NC
  • NPI 1669725198
  Medicare reassignment NPD
• Brunswick Physician Partners, PLLC

  • Emergency Medicine Physician
  • Bolivia, NC
  • NPI 1457822264
  Medicare reassignment NPD
• Forsyth Memorial Hospital, Inc.

  dba NH Forsyth Primary Care Clinics

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1104548874
  Medicare reassignment NPD
• Kernersville Emergency Group, PLLC

  • Emergency Medicine Physician
  • Kernersville, NC
  • NPI 1750852034
  Medicare reassignment NPD
• Piedmont Triad Physicians, PLLC

  • Emergency Medicine Physician
  • Thomasville, NC
  • NPI 1295206464
  Medicare reassignment NPD
• Tanglewood Park Physicians, PLLC

  • Emergency Medicine Physician
  • Clemmons, NC
  • NPI 1093286379
  Medicare reassignment NPD
• Emergency Coverage, LLC

  dba Emergency Coverage Corporation of TeamHealth

  • Family Medicine Physician
  • Newport, TN
  • NPI 1427005008

  Emergency Medicine, NC

  Medicare reassignment NPD
• Emergency Professional Services, Inc.

  dba Emergency Professional Services of Ohio, Inc.

  • Emergency Medicine Physician
  • Seaman, OH
  • NPI 1093762353
  Medicare reassignment NPD
• Pomerene Hospital

  • Critical Access Hospital
  • Millersburg, OH
  • NPI 1770957185
  Medicare reassignment NPD
• Forsyth Memorial Hospital Inc

  dba Novant Health Cancer Institute

  • Hematology & Oncology Physician
  • Kernersville, NC
  • NPI 1073823118
  NPD
• Forsyth Memorial Hospital, Inc.

  dba Novant Health Heart & Vascular Institute - Frontis Plaza

  • Cardiovascular Disease Physician
  • Winston Salem, NC
  • NPI 1932935475
  NPD
• Brunswick Community Hospital, LLC

  dba Novant Health Brunswick Medical Center

  • General Acute Care Hospital
  • Bolivia, NC
  • NPI 1710915756
  NPD (past)

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

{
    "created_epoch": "1362096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1275874109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 DEER COVE RD",
            "city": "HAMPSTEAD",
            "state": "NC",
            "postal_code": "284432398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 HOSPITAL DR NE",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284228346",
            "telephone_number": "910-721-1700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Brewster Blvd",
            "address_purpose": "LOCATION",
            "city": "Camp Lejeune",
            "state": "NC",
            "postal_code": "285472575",
            "country_code": "US",
            "telephone_number": "910-450-4357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALE",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-01",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "00000000000000000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "MILLER",
            "middle_name": "ANN",
            "credential": "D.O",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Timothy Michael Foeller, M.D.
• Kirsten Frostad, MHS, PA-C
• Amy Gilman, MS, OTRIL
• Gretchen Gigi Gorman-Lyden, D.D.S.
• Christine Elizabeth Grissett, CRNA
• Francis J Hanley, MS
• Mark Jamieson Hanna, DO
• Lori Ann Hanrahan, FNP
• Kerri Barbee Hardee, FNP-C
• Lorie L Harding, RPA C

• Emergency Medicine Physician in Bolivia, NC
• Providers in Bolivia, NC by specialty
• Emergency Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.