Individual provider Active NPI

William Timothy Jaegle, D.O.

  • Obstetrics & Gynecology Physician
  • Fort Moore, GA
National Provider Identifier
1881014710
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
1445 Issued in NE
Practice address
6600 Van Aalst Blvd
Fort Moore, GA 31905-2102
Phone
(627) 408-5057
NPI assigned
Apr 18, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 1445 NE
Obstetrics & Gynecology Physician 207V00000X 1445 NE Primary

Addresses

Primary practice location

6600 Van Aalst Blvd
Fort Moore, GA 31905-2102

Mailing address

6600 Van Aalst Blvd
Fort Benning, GA 31905-2102
Phone (627) 408-5057

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
I20250830000483 GA Practitioner - Obstetrics/Gynecology 7618301656 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1643 NW 136TH Ave
BLDG H Suite 100
Sunrise, FL 33351-6446

6600 Van Aalst Blvd
Fort Benning, GA 31905-2102

Department of Women'S Healht
6600 Van Aalst Blvd
Fort Benning, GA 31905

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1445NEMDBasic Emergency Medical Technician

Practice roles

OrganizationSpecialtyStatusNew patients
DHP of Piedmont PC Obstetrics & Gynecology CurrentSince Aug 27, 2025 Accepting new patients

Locations

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

1255 Highway 54 W
Fayetteville, GA 30214
Phone (770) 719-6911

Organizations & group practices 1

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": "1397779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1881014710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 VAN AALST BLVD",
            "city": "FORT BENNING",
            "state": "GA",
            "postal_code": "319052102",
            "telephone_number": "627-408-5057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 VAN AALST BLVD",
            "city": "FORT MOORE",
            "state": "GA",
            "postal_code": "319052102",
            "telephone_number": "627-408-5057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAEGLE",
        "first_name": "WILLIAM",
        "middle_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-18",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NE",
            "license": "1445",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NE",
            "license": "1445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Moore, GA

Sources for this page

Verify at the official NPI Registry.