Mark A Hailey, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

24221 Issued in CO

Practice address

914 W 6TH St
Loveland, CO 80537-5341

Phone

(970) 667-3976

Fax

(970) 667-8177

NPI assigned

Nov 18, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Big Thompson Medical Group Inc

  • Family Medicine Physician
  • Loveland, CO
  • NPI 1720011786
  NPD (past)

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208649600000",
    "number": "1376525733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1627 E 18TH ST",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805384209",
            "telephone_number": "970-663-0135",
            "fax_number": "970-461-1422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 W 6TH ST",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805375341",
            "telephone_number": "970-667-3976",
            "fax_number": "970-667-8177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAILEY",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2008-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "24221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD409CO",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01242213",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "HA65754",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phillip J Haberman, M.D.
• Gabriel Kyle Habermehl, M.D.
• Brooke Hackler, PTA
• Nichole Hadley
• Jennifer Hahn, LPC
• Kathrine Hale-King, RN
• Jack M. Haley
• Michael Jon Haley, LCSW
• Hall Chiropractic, P.C.
• Brandon D Hall, D.C.

• Family Medicine Physician in Loveland, CO
• Providers in Loveland, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.