Individual provider Active NPI

Loren Haynes Kleimeyer Halbrooks, PA-C

  • Surgical Physician Assistant
  • Marietta, GA
National Provider Identifier
1780008995
Registry record updated Mar 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
007089 Issued in GA
Practice address
300 Tower Rd NE Ste 200
Marietta, GA 30060-9403
Phone
(770) 427-5717
Fax
(770) 425-4183
NPI assigned
Feb 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 007089 GA
Surgical Physician Assistant 363AS0400X 007089 GA Primary

Addresses

Primary practice location

300 Tower Rd NE Ste 200
Marietta, GA 30060-9403

Mailing address

Northside Hospital- Managed Care Dept
1000 Johnson Ferry Rd
Atlanta, GA 30342-1606
Phone (404) 300-2476

Other identifiers 1

IdentifierTypeStateIssuer
202I976484OtherGAPTAN

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140415001451 GA Practitioner - Physician Assistant 7719119262 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Emory University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

61 Whitcher N E St
Suite 4120
Marietta, GA 30060-1179
Phone (770) 424-9732

61 Whitcher St NE
Suite 2100
Marietta, GA 30060-1179
Phone (770) 423-0595

625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004

677 Church Nest
Marietta, GA 30060-1101

677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Orthopaedics & Sports Medicine Specialists LLC CurrentSince Nov 16, 2015 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Sep 1, 2023 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Sep 1, 2023 Accepting new patients

Locations

100 Greystone Power Blvd
Dallas, GA 30157
Phone (678) 453-5717

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

300 Tower Rd NE
Ste 101
Marietta, GA 30060
Phone (770) 218-0219

300 Tower Rd NE
Ste 200
Marietta, GA 30060
Phone (770) 427-5717

3747 Roswell Rd
Ste 319
Marietta, GA 30062
Phone (770) 579-8558

Organizations & group practices 5

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": "1391731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551916800000",
    "number": "1780008995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NORTHSIDE HOSPITAL- MANAGED CARE DEPT",
            "address_2": "1000 JOHNSON FERRY RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421606",
            "telephone_number": "404-300-2476",
            "fax_number": "404-250-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 TOWER RD NE STE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609403",
            "telephone_number": "770-427-5717",
            "fax_number": "770-425-4183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALBROOKS",
        "first_name": "LOREN",
        "middle_name": "HAYNES KLEIMEYER",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-07",
        "last_updated": "2019-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "007089",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "007089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "202I976484",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.