NPIMap

Organization Active NPI

Hazlehurst Pediatrics, PC

  • Pediatrics Physician
  • Hazlehurst, GA
National Provider Identifier
1992900435
Registry record updated Jul 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
HAZLEHURST PEDIATRICS, PC
Practice address
143 S Tallahassee St
Hazlehurst, GA 31539-6466
Phone
(912) 375-3360
Fax
(912) 375-3365
NPI assigned
Jun 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2011

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

Authorized official

Name
Dr. Angela Patricia Highbaugh-Battle, MDNPI 1336261916
Title
Owner
Phone
(912) 375-3360

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

143 S Tallahassee St
Hazlehurst, GA 31539-6466

Mailing address

PO Box 630
Hazlehurst, GA 31539-0630
Phone (912) 375-3360

Other names 1

  • Hazlehurst Pediatrics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110829000364 GA Part B Supplier - Clinic/Group Practice 2668573460 Receives reassigned benefits from 3 practitioners
Practice locations: Hazlehurst, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311292800000",
    "number": "1992900435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 630",
            "city": "HAZLEHURST",
            "state": "GA",
            "postal_code": "315390630",
            "telephone_number": "912-375-3360",
            "fax_number": "912-375-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 S TALLAHASSEE ST",
            "city": "HAZLEHURST",
            "state": "GA",
            "postal_code": "315396466",
            "telephone_number": "912-375-3360",
            "fax_number": "912-375-3365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAZLEHURST PEDIATRICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-15",
        "last_updated": "2011-07-22",
        "status": "A",
        "authorized_official_last_name": "HIGHBAUGH-BATTLE",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-375-3360",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hazlehurst Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hazlehurst, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.