Individual provider Active NPI

Sharon G Haggerty, FNP

  • Family Nurse Practitioner
  • Moultrie, GA
National Provider Identifier
1295061612
Registry record updated Aug 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN152867 NP Issued in GA
Practice address
1401 S Main St
Moultrie, GA 31768-5811
Phone
(229) 891-3513
Fax
(229) 890-1986
NPI assigned
Oct 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN152867 NP GA Primary

Addresses

Primary practice location

1401 S Main St
Moultrie, GA 31768-5811

Mailing address

1401 S Main St
Moultrie, GA 31768-5811
Phone (229) 891-3513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120516000544 GA Practitioner - Nurse Practitioner 0749443463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group of Georgia LLCGroup PAC ID 4284951542, 454 clinicians

Practice addresses (Care Compare)

101 Yorktown Dr
Fayetteville, GA 30214-1578

101 Yorktown Dr
Suite 100
Fayetteville, GA 30214-7663
Phone (770) 460-4285

2402 Osler CT
Albany, GA 31707-0205
Phone (229) 438-3300

Hospital & facility affiliations

  • Phoebe Putney Memorial Hospital Hospital, Albany, GA, CCN 110007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN152867 NPGAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group of Georgia LLC CurrentSince Mar 3, 2020 Accepting new patients
Privia Medical Group of Georgia LLC CurrentSince Mar 3, 2020 Accepting new patients
Vascular Health and Wellness, LLC Past Accepting new patients

Locations

2300 Dawson Rd
Ste 101
Albany, GA 31707
Phone (229) 436-8535

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: haggerty.sharon.1@8042.direct.athenahealth.com

Organizations & group practices 3

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 1

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": "1255910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1295061612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S MAIN ST",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317685811",
            "telephone_number": "229-891-3513",
            "fax_number": "229-890-1986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S MAIN ST",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317685811",
            "telephone_number": "229-891-3513",
            "fax_number": "229-890-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGGERTY",
        "first_name": "SHARON",
        "middle_name": "G",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-19",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN152867 NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moultrie, GA

Sources for this page

Verify at the official NPI Registry.