Active NPI
Jeffrey H Hasty, MD
- Pediatrics Physician
- Kennesaw, GA
National Provider Identifier
1851382840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 021994
- Practice address
- 205 Hawkins Store Rd
Suite B 1
Kennesaw, GA 30144 - Phone
- (770) 928-0862
- Fax
- (770) 928-2286
- NPI assigned
- Oct 31, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 021994 | GA | Primary |
Addresses
Primary practice location
205 Hawkins Store Rd
Suite B 1
Kennesaw, GA 30144
Mailing address
205 Hawkins Store Rd
Suite B 1
Kennesaw, GA 30144
Phone (770) 928-0862
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021994 | GA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323388800000",
"number": "1851382840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 HAWKINS STORE RD",
"address_2": "SUITE B 1",
"city": "KENNESAW",
"state": "GA",
"postal_code": "30144",
"telephone_number": "770-928-0862",
"fax_number": "770-928-2286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 HAWKINS STORE RD",
"address_2": "SUITE B 1",
"city": "KENNESAW",
"state": "GA",
"postal_code": "30144",
"telephone_number": "770-928-0862",
"fax_number": "770-928-2286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HASTY",
"first_name": "JEFFREY",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-31",
"last_updated": "2011-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "021994",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kennesaw, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.