NPIMap

Individual provider Active NPI

Jeffrey Hale, MD

  • Diagnostic Radiology Physician
  • Russellville, AR
National Provider Identifier
1457301418
Registry record updated Jan 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
C8119 Issued in AR
Practice address
3301 W Main PL
Russellville, AR 72801-2334
Phone
(479) 968-7930
Fax
(479) 968-1673
NPI assigned
May 11, 2006
Last updated
Jan 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X C8119 AR Primary

Addresses

Primary practice location

3301 W Main PL
Russellville, AR 72801-2334

Mailing address

PO Box 9178
Russellville, AR 72811-9178
Phone (479) 968-7930

Other identifiers 2

IdentifierTypeStateIssuer
5J767OtherARARKANSAS BCBS NUMBER
127480001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20050516001022 AR Practitioner - Diagnostic Radiology 1456392869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Arkansas College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiologists of Russellville PAGroup PAC ID 4385741685, 27 clinicians

Practice addresses (Care Compare)

1808 W Main St
St Mary's Regional Medical Center
Russellville, AR 72801-2724
Phone (479) 968-2841

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
54.89 of 100Reported as individual
Quality
77.5
Improvement activities
0
Cost
74.58

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C8119ARMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiologists of Russellville PA Diagnostic Radiology CurrentSince Jul 1, 1995 Accepting new patients

Locations

1100 E Poplar St
Clarksville, AR 72830
Phone (479) 754-5393

1808 W Main St
Russellville, AR 72801
Phone (479) 964-4178

3301 W Main Pl
Russellville, AR 72801
Phone (855) 498-6768

Organizations & group practices 1

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547164800000",
    "number": "1457301418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9178",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728119178",
            "telephone_number": "479-968-7930",
            "fax_number": "479-968-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 W MAIN PL",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012334",
            "telephone_number": "479-968-7930",
            "fax_number": "479-968-1673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALE",
        "first_name": "JEFFREY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2019-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AR",
            "license": "C8119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS BCBS NUMBER",
            "identifier": "5J767",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127480001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, AR

Sources for this page

Verify at the official NPI Registry.