Active NPI
Jason Andrew Halley, DO
- Emergency Medicine Physician
- Augusta, GA
National Provider Identifier
1760018188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 2021028956
- Practice address
- 1120 15TH St
Augusta, GA 30912-0006 - Phone
- (785) 239-7151
- NPI assigned
- Mar 17, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 2021028956 | MO | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | 2021028956 | MO | Primary |
Addresses
Primary practice location
1120 15TH St
Augusta, GA 30912-0006
Mailing address
1120 15TH St
Augusta, GA 30912-0006
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021028956 | MO | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714435200000",
"number": "1760018188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 15TH ST",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309120006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 15TH ST",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309120006",
"telephone_number": "785-239-7151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALLEY",
"first_name": "JASON",
"middle_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-17",
"last_updated": "2024-04-30",
"certification_date": "2024-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "MO",
"license": "2021028956",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MO",
"license": "2021028956",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.