Jahmal A Hairston, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

056293 Issued in GA

Practice address

6130 Prestley Mill Rd Ste C
Douglasville, GA 30134-2288

Phone

(678) 838-3903

Fax

(678) 838-7454

NPI assigned

Nov 3, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Otolaryngology

Education

University of Virginia School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Ear, Nose and Throat Plastic Surgery CenterGroup PAC ID 2961497318, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
• Wellstar Douglas Medical Center Hospital, Douglasville, GA, CCN 110184
• Northside Hospital Hospital, Atlanta, GA, CCN 110161
• Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Ear, Nose & Throat Plastic Surgery Center

  • Otolaryngology/Facial Plastic Surgery Physician
  • Douglasville, GA
  • NPI 1821163577
  Medicare reassignment Care Compare group NPD
• Northside Surgical Professional Services LLC

  • Surgery Physician
  • Atlanta, GA
  • NPI 1356630990
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cobb Hospital, Inc

  dba Wellstar Cobb Hospital

  • General Acute Care Hospital
  • Austell, GA
  • NPI 1467420448
  Care Compare affiliation
• Douglas Hospital, Inc.

  dba Wellstar Douglas Hospital

  • General Acute Care Hospital
  • Douglasville, GA
  • NPI 1649247974
  Care Compare affiliation
• Kennestone Hospital, Inc.

  dba Wellstar Kennestone Hospital

  • General Acute Care Hospital
  • Marietta, GA
  • NPI 1649248626
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922187871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6130 PRESTLEY MILL RD STE C",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342288",
            "telephone_number": "678-838-3903",
            "fax_number": "678-838-7454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6130 PRESTLEY MILL RD STE C",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342288",
            "telephone_number": "678-838-3903",
            "fax_number": "678-838-7454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIRSTON",
        "first_name": "JAHMAL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "056293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P00310275",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joan P. Haase, RPH
• Ashley Hackett, LPC
• Alec Hagan, RBT
• Joe F Hair Jr., D.M.D.
• Chris Hairston
• John R Hairston Jr.
• Terrance Hale
• Danielle Ashely Hall
• Jasmine Kiana Hall, BS, RBT
• Jennifer Hall, LMT

• Otolaryngology Physician in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Otolaryngology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.