Individual provider Active NPI

William H Pullen Jr., MD

  • General Practice Physician
  • Dalton, GA
National Provider Identifier
1629009105
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
017270 Issued in GA
Practice address
1200 Memorial Dr
Dalton, GA 30720-2529
Phone
(706) 278-2105
Fax
(865) 291-3228
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 017270 GA
General Practice Physician 208D00000X 017270 GA Primary

Addresses

Primary practice location

1200 Memorial Dr
Dalton, GA 30720-2529

Mailing address

1200 Memorial Dr
Dalton, GA 30720-2529
Phone (706) 272-6596

Other identifiers 2

IdentifierTypeStateIssuer
P00242810OtherGARAILROAD MEDICARE
000139609EMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wpullen@hamilton.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20040413000064 GA Practitioner - General PracticePractitioner - Emergency Medicine 7517853286 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A41473CAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hamilton Medical Center, Inc. CurrentSince Feb 1, 2016 Accepting new patients
Hamilton Physician Group Inc CurrentSince Feb 1, 2016 Accepting new patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Jul 1, 2005 Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients

Locations

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

Interoperability endpoints

  • Direct secure messaging: wpullen@hamilton.cernerdirect.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1629009105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 MEMORIAL DR",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202529",
            "telephone_number": "706-272-6596",
            "fax_number": "706-272-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 MEMORIAL DR",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202529",
            "telephone_number": "706-278-2105",
            "fax_number": "865-291-3228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLEN",
        "first_name": "WILLIAM",
        "middle_name": "H",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "017270",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "017270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00242810",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000139609E",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wpullen@hamilton.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Hamilton Medical Center",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1200 Memorial Dr",
            "city": "Dalton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "307202529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.