Individual provider Active NPI

Jennifer Sue Hatfield, D.O.

  • Endocrinology, Diabetes & Metabolism Physician
  • Fort Eisenhower, GA
National Provider Identifier
1306379672
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
0102205455 Issued in VI
Practice address
300 E Hospital Road
Fort Eisenhower, GA 30905
Phone
(706) 787-2875
Fax
(706) 787-2326
NPI assigned
Apr 4, 2017
Last updated
Nov 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 0102205455 VA
Student in an Organized Health Care Education/Training Program 390200000X
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 0102205455 VI Primary

Addresses

Primary practice location

300 E Hospital Road
Fort Eisenhower, GA 30905

Mailing address

3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504
Phone (210) 916-5910

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20190211000556 VA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8527306927

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102205455VIMDEndocrinology, Diabetes & Metabolism Physician

NPI Registry JSON

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1306379672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-5910",
            "fax_number": "210-916-2077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E HOSPITAL ROAD",
            "city": "FORT EISENHOWER",
            "state": "GA",
            "postal_code": "30905",
            "telephone_number": "706-787-2875",
            "fax_number": "706-787-2326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATFIELD",
        "first_name": "JENNIFER",
        "middle_name": "SUE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-04",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0102205455",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "VI",
            "license": "0102205455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Eisenhower, GA

Sources for this page

Verify at the official NPI Registry.