DR. JEFFREY HALLER (NPI# 1659467629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659467629 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY HALLER |
| Credential | MD |
| Practice Address |
104 Prominence Point Pkwy Ste 104 Canton GA 30114-1236 |
| Mailing Address |
Po Box 102321 Atlanta GA 30368-2321 |
| Practice Telephone | 7707046988 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2013-08-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 055826 | GA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417935032 | Jeffrey D Haller | Internal Medicine | 27555 Farmington Rd 120, Farmington Hills, MI 48334-3376 | 2006-01-04 |
| 1144328899 | Jeffrey Ezra Haller | Internal Medicine | 1999 Marcus Ave, Suite 216, New Hyde Park, NY 11042-1017 | 2006-09-20 |
| 1326084021 | Jeffrey M. Haller | Internal Medicine | 1700 Geary St Se, Albany, OR 97322-6842 | 2006-06-21 |
| 1194712307 | Jeffrey Haller | Otolaryngology | 700 W Kent Ave, Missoula, MT 59801-6772 | 2005-10-03 |
| Street Address |
104 PROMINENCE POINT PKWY STE 104 |
| City | CANTON |
| State | GA |
| Zip Code | 30114-1236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477978799 | Digestive Healthcare of Ga, P.C. | Internal Medicine | 104 Prominence Point Pkwy, Suite 104, Canton, GA 30114-1236 | 2014-02-24 |
| 1043657521 | Ambreen Mardhani | Family Medicine | 104 Prominence Point Pkwy, Suite 104, Canton, GA 30114-1236 | 2013-05-24 |
| 1013253103 | Amy Marie Wheeler | Nurse Practitioner | 104 Prominence Point Pkwy, Suite 104, Canton, GA 30114-1236 | 2012-12-18 |
| 1912123761 | Kathryn G Brady | Physician Assistant | 104 Prominence Point Pkwy, Suite 104, Canton, GA 30114-1236 | 2007-04-18 |
| 1083778989 | Brenda Gail Fritz | Dentist | 104 Prominence Point Pkwy, Suite 102, Canton, GA 30114-1236 | 2006-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619516093 | Wickshire Canton Opco LLC | Assisted Living Facility | 125 Riverstone Terrace, Canton, GA 30114 | 2020-01-02 |
| 1154803583 | Alixandra Nicole Flournoy | Physical Therapist | 131 Holly Street, Canton, GA 30114 | 2018-09-01 |
| 1588157341 | Provident Group - Canton Cove Properties LLC | Alzheimer Center (Dementia Center) | 1100 Reinhardt College Parkway, Canton, GA 30114 | 2018-06-07 |
| 1003233107 | Heartland Dental Care of Georgia | Dentist | 3237 Sixes Rd, Canton, GA 30114 | 2014-03-26 |
| 1730510959 | Joseph Optical | Eyewear Supplier (Equipment, not the service) | 1455 Riverstone Pkwy Suite 110, Canton, GA 30114 | 2013-12-13 |
| 1629313036 | Ramona Morton Rasmussen | Occupational Therapist | 200 Riverstone Drive, Suite B, Canton, GA 30114 | 2012-12-11 |
| 1902154875 | Yong Qiao Luo | Acupuncturist | 200 Oakside Lane, Suite D, Canton, GA 30114 | 2012-08-26 |
| 1215294350 | Christina Lynn Hernandez | Pediatrics | 1558 Riverstone Pkwy Ste 100, Canton, GA 30114 | 2012-04-13 |
| 1558638981 | Stephen E Byrd | Counselor | 191 Lamar Haley Pkwy., Canton, GA 30114 | 2011-11-30 |
| 1073807855 | Sheri Sullins Buckley | Nurse Practitioner | 120 Oakside Ct Ste H, Canton, GA 30114 | 2011-06-08 |
| Find all providers in zip 30114 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124629365 | Dima Healthcare, Inc | Family Medicine | 7768 Cumming Hwy Ste 300, Canton, GA 30115-2982 | 2020-11-04 |
| 1396342606 | Kiwi Virtual Health Care Pllc | Family Medicine | 40618 Blythefield Ln, Canton, MI 48188-2251 | 2020-10-08 |
| 1417571142 | K Loor Medical LLC | Family Medicine | 1750 Marietta Hwy Ste 250, Canton, GA 30114-8388 | 2020-05-28 |
| 1336762913 | Favor Family Medical Practice | Family Medicine | 103 Mountain Brook Dr Ste 100, Canton, GA 30115-9078 | 2020-05-18 |
| 1679051213 | Edward Arthur Hill | Family Medicine | 6104 Cedar Lane Nw, Canton, OH 44708 | 2018-08-06 |
| 1073012118 | Mea Primary Care Plus LLC | Family Medicine | 112 Southlake Cir, Canton, MS 39046-5368 | 2018-02-05 |
| 1629592175 | Healthy U Academy, LLC | Family Medicine | 1226 Market Ave N, Canton, OH 44714-2604 | 2017-07-26 |
| 1629508114 | Zeinab M Makki | Family Medicine | 7330 N Canton Center Rd Ste 111, Canton, MI 48187-1538 | 2017-06-15 |
| 1366805210 | Michael Wowk | Family Medicine | 1600 S Canton Center Rd Ste 220, Canton, MI 48188-6276 | 2016-03-29 |
| 1184036832 | Courtney Weaver | Family Medicine | 15 Reinhardt College Pkwy Ste 100, Canton, GA 30114-5259 | 2014-05-29 |
| Find all providers in CANTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.