NPIMap

Individual provider Active NPI

Zachary James Hale, APRN, NP-C

  • Primary Care Nurse Practitioner
  • Beavercreek, OH
National Provider Identifier
1356992028
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APRN.CNP.025696 Issued in OH
Practice address
68 Darst Rd
Beavercreek, OH 45440-3442
Phone
(937) 458-4900
NPI assigned
Sep 24, 2019
Last updated
Jan 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X APRN.CNP.025696 OH Primary

Addresses

Primary practice location

68 Darst Rd
Beavercreek, OH 45440-3442

Mailing address

8911 Cam Dr
Franklin, OH 45005-3001
Phone (937) 825-5517

Other identifiers 1

IdentifierTypeStateIssuer
0374476MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address zhale548215@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20191118003119 OH Practitioner - Nurse Practitioner 4284066952 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shiloh Family Medicine LLCGroup PAC ID 7214051531, 3 clinicians

Practice addresses (Care Compare)

5900 N Main St
Suite 3
Dayton, OH 45415-3106
Phone (937) 277-9371

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.11 of 100Reported as group
Quality
81.92
Promoting interoperability
100
Improvement activities
40
Cost
81.77

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shiloh Family Medicine LLC CurrentSince Nov 10, 2022 Accepting new patients
Wholelife Functional Medicine LLC CurrentSince Sep 29, 2019 Accepting new patients

Locations

5900 N Main St
Ste 3
Dayton, OH 45415
Phone (937) 277-9371

Organizations & group practices 2

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 3

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": "1569283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1356992028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8911 CAM DR",
            "city": "FRANKLIN",
            "state": "OH",
            "postal_code": "450053001",
            "telephone_number": "937-825-5517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 DARST RD",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454403442",
            "telephone_number": "937-458-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALE",
        "first_name": "ZACHARY",
        "middle_name": "JAMES",
        "credential": "APRN, NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-24",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OH",
            "license": "APRN.CNP.025696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0374476",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "zhale548215@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "68 Darst Rd",
            "city": "Beavercreek",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454403442",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "68 Darst Rd",
            "city": "Beavercreek",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454403442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

Verify at the official NPI Registry.