Individual provider Active NPI

Patricia M Haibach, DO

  • Hospitalist Physician
  • Griffin, GA
National Provider Identifier
1790713550
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
057370 Issued in GA
Practice address
601 South Eight Street - Hospital Medicine Department
Spalding Regional Medical Center
Griffin, GA 30224
Phone
(770) 467-6310
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 057370 GA
Hospitalist Physician 208M00000X 057370 GA Primary

Addresses

Primary practice location

601 South Eight Street - Hospital Medicine Department
Spalding Regional Medical Center
Griffin, GA 30224

Mailing address

PO Box V
601 South Eighth Street
Griffin, GA 30224-0047
Phone (770) 467-6310

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
I20061012000360 GA Practitioner - Internal MedicinePractitioner - Hospice/Palliative Care 0840296919 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
057370GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Athens Hospitalist Physicians LLC Internal Medicine CurrentSince Aug 1, 2018 Accepting new patients
Piedmont Athens Specialty Care LLC Past Accepting new patients

Locations

1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520

35 Collier Rd NW
Ste 635
Atlanta, GA 30309
Phone (404) 367-3000

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.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529539200000",
    "number": "1790713550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX V",
            "address_2": "601 SOUTH EIGHTH STREET",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302240047",
            "telephone_number": "770-467-6310",
            "fax_number": "678-990-7236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 SOUTH EIGHT STREET - HOSPITAL MEDICINE DEPARTMENT",
            "address_2": "SPALDING REGIONAL MEDICAL CENTER",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "30224",
            "telephone_number": "770-467-6310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIBACH",
        "first_name": "PATRICIA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2018-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "057370",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "057370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Griffin, GA

Sources for this page

Verify at the official NPI Registry.