NPIMap

Individual provider Active NPI

Anna Marie Hailey-Sharp, MD

  • Family Medicine Physician
  • De Kalb, MS
National Provider Identifier
1467716860
Registry record updated Aug 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
T-2554 Issued in MS
Practice address
14365 Highway 16 W
De Kalb, MS 39328-7974
Phone
(601) 743-4626
Fax
(601) 743-2133
NPI assigned
Jun 29, 2012
Last updated
Aug 14, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X T-2554 MS Primary

Addresses

Primary practice location

14365 Highway 16 W
De Kalb, MS 39328-7974

Mailing address

1314 19TH Ave
Meridian, MS 39301-4116
Phone (601) 703-3018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20151114000136 MS Practitioner - Family Practice 2567788995 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Mississippi School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kemper Cah, Inc.Group PAC ID 5991985012, 28 clinicians

Practice addresses (Care Compare)

30 Ponderosa Ave
De Kalb, MS 39328-9104
Phone (601) 743-4626

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T-2554MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kemper Cah, Inc CurrentSince Oct 1, 2015 Accepting new patients
Kemper Cah, Inc. Current Accepting new patients

Locations

14365 Highway 16 W
De Kalb, MS 39328
Phone (769) 486-1000

1314 19th Ave
Meridian, MS 39301
Phone (601) 483-0011

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 8

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": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439510400000",
    "number": "1467716860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 19TH AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014116",
            "telephone_number": "601-703-3018",
            "fax_number": "601-703-9283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14365 HIGHWAY 16 W",
            "city": "DE KALB",
            "state": "MS",
            "postal_code": "393287974",
            "telephone_number": "601-743-4626",
            "fax_number": "601-743-2133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAILEY-SHARP",
        "first_name": "ANNA MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-29",
        "last_updated": "2015-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "T-2554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in De Kalb, MS

Sources for this page

Verify at the official NPI Registry.