Individual provider Active NPI

Betty Jo Haswell, PA-C

  • Physician Assistant
  • Chapel Hill, NC
National Provider Identifier
1750441184
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
101679 Issued in NC
Practice address
1728 Fordham Blvd
151 Ram'S Plaza
Chapel Hill, NC 27514-2397
Phone
(919) 968-1985
Fax
(919) 942-0038
NPI assigned
Dec 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 101679 NC Primary

Addresses

Primary practice location

1728 Fordham Blvd
151 Ram'S Plaza
Chapel Hill, NC 27514-2397

Mailing address

1728 Fordham Blvd
151 Ram'S Plaza
Chapel Hill, NC 27514-2397
Phone (919) 968-1985

Other identifiers 1

IdentifierTypeStateIssuer
101679OtherNCMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20050131000338 NC Practitioner - Physician Assistant 9133179807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Med First Immediate Care and Family Practice PAGroup PAC ID 0446332720, 94 clinicians

Practice addresses (Care Compare)

1800 E Franklin St
Suite 11a
Chapel Hill, NC 27514-1867
Phone (919) 968-1985

609 Richlands Hwy 6
Jacksonville, NC 28540-3606
Phone (910) 455-7888

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
101679NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Foot and Ankle Centers Past Accepting new patients
Med First Immediate Care & Family Practice PA Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: betty.haswell.1@1905.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1750441184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1728 FORDHAM BLVD",
            "address_2": "151 RAM'S PLAZA",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275142397",
            "telephone_number": "919-968-1985",
            "fax_number": "919-942-0038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1728 FORDHAM BLVD",
            "address_2": "151 RAM'S PLAZA",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275142397",
            "telephone_number": "919-968-1985",
            "fax_number": "919-942-0038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASWELL",
        "first_name": "BETTY",
        "middle_name": "JO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "101679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "101679",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.