NPIMap

Individual provider Active NPI

Haley Phillips, M.D.

  • Neurology Physician
  • Atlanta, GA
National Provider Identifier
1316394398
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
85262 Issued in GA
Practice address
12 Executive Park Dr NE
Atlanta, GA 30329-2206
Phone
(248) 861-3750
NPI assigned
May 19, 2016
Last updated
Sep 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 11018683A IN
Neurology Physician 2084N0400X 85262 GA Primary

Addresses

Primary practice location

12 Executive Park Dr NE
Atlanta, GA 30329-2206

Mailing address

12 Executive Park Dr NE Ste 400
Atlanta, GA 30329-2206

Other practice location 1

1120 W Michigan St
CL626 Gatch Hall
Indianapolis, IN 46202-5209
Phone (317) 278-2694

Other identifiers 1

IdentifierTypeStateIssuer
11018683AOtherINMEDICAL RESIDENCY PERMIT

Other names 1

  • Haley Kathol Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220616000226 NE Practitioner - NeurologyPractitioner - Epileptologists 3577854470 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Faith Regional Health ServicesGroup PAC ID 8921902966, 19 clinicians
Unmc PhysiciansGroup PAC ID 6002728391, 1,490 clinicians

Practice addresses (Care Compare)

2700 W Norfolk Ave
Faith Health
Norfolk, NE 68701-4438
Phone (402) 371-4880

4242 Farnam St
Suite 650
Omaha, NE 68131-2813
Phone (402) 559-8600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
85262GAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faith Regional Health Services CurrentSince Jul 27, 2025 Accepting new patients
Unmc Physicians CurrentSince Jul 15, 2022 Accepting new patients
Faith Regional Health Services CurrentSince Jul 27, 2025 Accepting new patients
The Nebraska Medical Center Past Accepting new patients

Locations

2700 W Norfolk Ave
Norfolk, NE 68701
Phone (402) 644-7131

4242 Farnam St
Ste 650
Omaha, NE 68131
Phone (402) 502-8787

Emile 42nd St
Omaha, NE 68198
Phone (402) 552-6731

Interoperability endpoints

  • Direct secure messaging: hphillips370905@direct.nebraskamed.com

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1463616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1316394398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 EXECUTIVE PARK DR NE STE 400",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 EXECUTIVE PARK DR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292206",
            "telephone_number": "248-861-3750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1120 W Michigan St",
            "address_2": "CL626 Gatch Hall",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025209",
            "country_code": "US",
            "telephone_number": "317-278-2694",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "HALEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-19",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11018683A",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "85262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL RESIDENCY PERMIT",
            "identifier": "11018683A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HALEY",
            "last_name": "KATHOL",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.