Individual provider Active NPI

Paul David Haver, M.D.

  • Family Medicine Physician
  • Athens, GA
National Provider Identifier
1770578155
Registry record updated Mar 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
031605 Issued in GA
Practice address
2205 Barnett Shoals Rd
Athens, GA 30605-3605
Phone
(706) 548-1555
Fax
(706) 548-1577
NPI assigned
Sep 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2017

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 031605 GA Primary

Addresses

Primary practice location

2205 Barnett Shoals Rd
Athens, GA 30605-3605

Mailing address

2205 Barnett Shoals Rd
Athens, GA 30605-3605
Phone (706) 548-1555

Other identifiers 1

IdentifierTypeStateIssuer
000475329AMedicaidGA

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
I20100209000004 GA Practitioner - Family Practice 8921141268 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Georgia School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athens Family MedicineGroup PAC ID 1658670492, 2 clinicians

Practice addresses (Care Compare)

2205 Barnett Shoals Rd
Athens, GA 30605-3605
Phone (706) 548-1555

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
031605GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Athens Family Medicine Family Medicine CurrentSince Jun 1, 2014 Accepting new patients
Northeast Georgia House Calls LLC Family Medicine CurrentSince Feb 1, 2020 Accepting new patients

Locations

2205 Barnett Shoals Rd
Athens, GA 30605
Phone (706) 410-7636

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EEEBBD

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488758400000",
    "number": "1770578155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 BARNETT SHOALS RD",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306053605",
            "telephone_number": "706-548-1555",
            "fax_number": "706-548-1577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 BARNETT SHOALS RD",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306053605",
            "telephone_number": "706-548-1555",
            "fax_number": "706-548-1577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVER",
        "first_name": "PAUL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2017-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "031605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000475329A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.