Individual provider Active NPI

Dalton Haslam, M.D.

  • Pediatrics Physician
  • Washington, DC
National Provider Identifier
1386177467
Registry record updated May 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD048305 Issued in DC
Practice address
111 Michigan Ave NW
Washington, DC 20010-2916
Phone
(202) 476-5000
NPI assigned
Apr 6, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD048305 DC Primary

Addresses

Primary practice location

111 Michigan Ave NW
Washington, DC 20010-2916

Mailing address

PO Box 744785
Atlanta, GA 30374-4785
Phone (202) 476-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20200601000514 DC Practitioner - Pediatric MedicinePractitioner - Hospitalist 6002155983 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital CurrentSince May 5, 2020 Accepting new patients
Children's Hospital Current Accepting new patients
Children's Hospital Pediatrics CurrentSince May 5, 2020 Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

101 Hospital Center Blvd
Stafford, VA 22554
Phone (540) 741-3340

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1491436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1386177467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744785",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744785",
            "telephone_number": "202-476-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MICHIGAN AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102916",
            "telephone_number": "202-476-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASLAM",
        "first_name": "DALTON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-06",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "DC",
            "license": "MD048305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.