NPIMap

Individual provider Active NPI

Jason Robert Hefner, MD

  • Internal Medicine Physician
  • Holly Springs, GA
National Provider Identifier
1902012206
Registry record updated Jun 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
061444 Issued in GA
Practice address
684 Sixes Rd
Suite 125
Holly Springs, GA 30115-8721
Phone
(678) 426-5450
Fax
(678) 426-5454
NPI assigned
May 15, 2007
Last updated
Jun 28, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2010

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 061444 GA Primary
Pediatrics Physician 208000000X 061444 GA

Addresses

Primary practice location

684 Sixes Rd
Suite 125
Holly Springs, GA 30115-8721

Mailing address

684 Sixes Rd
125
Holly Springs, GA 30115
Phone (678) 426-5450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081226000165 GA Practitioner - General Practice 7517029614 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
University Alabama Birmingham - School of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Medical Care CorporationGroup PAC ID 6002802220, 368 clinicians

Practice addresses (Care Compare)

105 Collier Rd NW
Suite 5020
Atlanta, GA 30309-1731
Phone (404) 367-3210

15 Reinhardt College Pkwy
Suite 100
Canton, GA 30114-5259
Phone (770) 704-6988

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Medical Care Corporation Internal Medicine CurrentSince Jan 1, 2011 Accepting new patients
Piedmont Providers LLC Internal Medicine Past Accepting new patients
Northside Urgent Care Holding, LLC Past Accepting new patients
Northside Cherokee Urgent Care, LLC Past Accepting new patients

Locations

105 Collier Rd NW
Ste 2070
Atlanta, GA 30309
Phone (404) 350-3860

105 Collier Rd NW
Ste 5020
Atlanta, GA 30309
Phone (404) 350-3860

2727 Paces Ferry Rd SE
Ste 1-1100
Atlanta, GA 30339
Phone (470) 271-3421

15 Reinhardt College Pkwy
Ste 110A
Canton, GA 30114
Phone (770) 720-2383

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277683200000",
    "number": "1902012206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "684 SIXES RD",
            "address_2": "125",
            "city": "HOLLY SPRINGS",
            "state": "GA",
            "postal_code": "30115",
            "telephone_number": "678-426-5450",
            "fax_number": "678-426-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "684 SIXES RD",
            "address_2": "SUITE 125",
            "city": "HOLLY SPRINGS",
            "state": "GA",
            "postal_code": "301158721",
            "telephone_number": "678-426-5450",
            "fax_number": "678-426-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEFNER",
        "first_name": "JASON",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2010-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "061444",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "061444",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holly Springs, GA

Sources for this page

Verify at the official NPI Registry.