Jack M. Haley

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.000735 Issued in CO

Practice address

2000 N. Boise Ave.
Loveland, CO 80538-7282

Phone

(970) 635-4071

Fax

(303) 306-7753

NPI assigned

Feb 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Jack M. Haley Professional name

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jack.haley.p1@direct.vwhs.nextgenshare.com

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.

• Valley-Wide Health Systems, Inc

  • Federally Qualified Health Center (FQHC)
  • Alamosa, CO
  • NPI 1790998953
  Medicare reassignment NPD
• Big Thompson Emergency Physicians, PC

  • Emergency Medicine Physician
  • Loveland, CO
  • NPI 1598365330

  Physician Assistant

  NPD
• Valley-Wide Health Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Alamosa, CO
  • NPI 1205652047
  NPD
• Valley-Wide Health Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Canon City, CO
  • NPI 1215383500
  NPD (past)
• Valley-Wide Health Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Buena Vista, CO
  • NPI 1972111953
  NPD (past)
• Quantum Plus LLC

  • Emergency Medicine Physician
  • Pleasanton, CA
  • NPI 1235188962

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438300800000",
    "number": "1477529519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 173817",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802178643",
            "telephone_number": "303-306-7783",
            "fax_number": "303-306-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 N. BOISE AVE.",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805387282",
            "telephone_number": "970-635-4071",
            "fax_number": "303-306-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALEY",
        "first_name": "JACK",
        "middle_name": "M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2015-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "735",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.000735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01331724",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55625029",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACK",
            "last_name": "HALEY",
            "middle_name": "M.",
            "credential": "PA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Brooke Hackler, PTA
• Nichole Hadley
• Jennifer Hahn, LPC
• Mark A Hailey, MD
• Kathrine Hale-King, RN
• Michael Jon Haley, LCSW
• Hall Chiropractic, P.C.
• Brandon D Hall, D.C.
• Heather Hall
• Kristy Hall, DSC, BCHN

• Physician Assistant in Loveland, CO
• Providers in Loveland, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.