DR. HALEY MARIE MCKISSACK MD
NPI 1275152019
Orthopaedic Surgery - Sports Medicine in Atlanta, GA
NPI Status: Active since April 12, 2020
Contact Information
59 EXECUTIVE PARK S
ATLANTA, GA
ZIP 30329
Phone: (404) 778-3350
Some details in this NPI profile have been updated in the NPI registry within the last 30 days.
- Individual
- Female
- Orthopaedic Surgery
- Sports Medicine
- PECOS Enrolled
About HALEY MCKISSACK
This page provides the complete NPI Profile along with additional information for Haley Mckissack, a provider established in Atlanta, Georgia with a medical specialization in Orthopaedic Surgery, focusing in sports medicine . The healthcare provider is registered in the NPI registry with number 1275152019 assigned on April 2020. The practitioner's primary taxonomy code is 207XX0005X with license number DR.0074792 (CO). The provider is registered as an individual and her NPI record was last updated June 2025.
- NPI
- 1275152019
- Provider Name
- DR. HALEY MARIE MCKISSACK MD
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 59 EXECUTIVE PARK S ATLANTA, GA 30329
- Location Phone
- (404) 778-3350
- Mailing Address
- 59 EXECUTIVE PARK S ATLANTA, GA 30329
- Mailing Phone
- (404) 778-3350
- Is Sole Proprietor?
- No
- Enumeration Date
- 04-12-2020
- Last Update Date
- 06-23-2025
- Code Navigator
Location Map
Secondary Locations
- 1635 Aurora Ct
Aurora, CO 80045
(720) 848-1900
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Orthopaedic Surgery Sports Medicine
- Taxonomy Code
- 207XX0005X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- DR.0074792
- License State
- CO
- Taxonomy Description
- An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | DR.0074792 (CO) |
Medicare Participation & PECOS Enrollment Status
Haley Mckissack is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Reviews for DR. HALEY MARIE MCKISSACK MD
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 7 | 5 | 1 | 5 | 2 | 0 | 1 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 14 | 5 | 2 | 5 | 4 | 0 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 1 + 4 + 5 + 2 + 5 + 4 + 0 + 2 + 24 = 51 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 51 = 9 | 9 | ||||||||
The NPI number 1275152019 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1295761450 | GREG ERENS MD Individual | Orthopaedic Surgery (Adult Reconstructive Orthopaedic Surgery) | 59 EXECUTIVE PARK S SUITE 2000 ATLANTA, GA 30329 (404) 778-3347 |
| 1578630117 | MR. ERIC ROBERT GUNDERSON MS, ATC, OTC Individual | Specialist/Technologist (Athletic Trainer) | 59 EXECUTIVE PARK S EMORY ORTHOPAEDIC AND SPINE CENTER ATLANTA, GA 30329 (404) 778-7137 |
| 1881848828 | THE EMORY CLINIC, INC Organization | Orthopaedic Surgery | 59 EXECUTIVE PARK S ATLANTA, GA 30329 (404) 778-7000 |
| 1982841920 | DR. PRAVEEN YALAMANCHILI MD Individual | Orthopaedic Surgery | 59 EXECUTIVE PARK S ATLANTA, GA 30329 (404) 778-3611 |
| 1336456748 | ATLANTA PROSTHETICS & ORTHOTICS THERAPY DIVISION,LLC Organization | Clinic/Center (Rehabilitation) | 59 EXECUTIVE PARK S SUITE 4100 ATLANTA, GA 30329 (404) 636-0321 |
| 1013214683 | MEGAN HIMES MED, ATC, OTC Individual | Specialist | 59 EXECUTIVE PARK S ATLANTA, GA 30329 (404) 778-7137 |
| 1932542859 | JESSICA ELAINE SCOTT PA Individual | Physician Assistant | 59 EXECUTIVE PARK S SUITE 3000 ATLANTA, GA 30329 (404) 778-3350 |
| 1033351192 | DI CUI Individual | Physical Medicine & Rehabilitation | 59 EXECUTIVE PARK S #2000 ATLANTA, GA 30329 (404) 778-7138 |
| 1427054386 | ATLANTA PROSTHETICS & ORTHOTICS, INC. Organization | Prosthetic/Orthotic Supplier | 59 EXECUTIVE PARK S SUITE 1300 ATLANTA, GA 30329 (404) 636-0321 |
| 1114343605 | REBECCA JANE BEDARD ATC Individual | 59 EXECUTIVE PARK S SUITE 1000 ATLANTA, GA 30329 (404) 778-7137 | |
| 1164666038 | DR. JACK ARTHUR TALSMA M.D. Individual | Radiology (Diagnostic Radiology) | 59 EXECUTIVE PARK S 4TH FLOOR SUITE 4009 ATLANTA, GA 30329 (404) 778-5834 |
| 1417364019 | DR. DANNY GILLIS M.D. Individual | Orthopaedic Surgery | 59 EXECUTIVE PARK S SUITE 1000 ATLANTA, GA 30329 (404) 778-6970 |
| 1740482850 | JASON TYLER BARITEAU M.D. Individual | Orthopaedic Surgery (Foot and Ankle Surgery) | 59 EXECUTIVE PARK S SUITE 2000 ATLANTA, GA 30329 (404) 778-5277 |
| 1164828604 | KATHRYN BONECUTTER ATC Individual | Specialist/Technologist (Athletic Trainer) | 59 EXECUTIVE PARK S SUITE 1000 ATLANTA, GA 30329 (404) 778-7176 |
| 1720019698 | DR. THOMAS LANE BRADBURY JR. MD Individual | Orthopaedic Surgery (Adult Reconstructive Orthopaedic Surgery) | 59 EXECUTIVE PARK S ATLANTA, GA 30329 (404) 778-7188 |
| 1689059180 | ELISABETH PETTIT BERMAN N.P. Individual | Nurse Practitioner (Adult Health) | 59 EXECUTIVE PARK S ATLANTA, GA 30329 (404) 778-7000 |
| 1417272576 | DR. ADAM DANIEL SINGER M.D. Individual | Radiology (Diagnostic Radiology) | 59 EXECUTIVE PARK S SUITE 4009 ATLANTA, GA 30329 (770) 842-5295 |
| 1477863157 | KIMBERLY FAITH MELVAN DPT Individual | Physical Therapist (Orthopedic) | 59 EXECUTIVE PARK S SUITE 1100 ATLANTA, GA 30329 (404) 778-6330 |
| 1366803959 | RACHEL ZGRABIK ATC Individual | Specialist/Technologist (Athletic Trainer) | 59 EXECUTIVE PARK S ATLANTA, GA 30329 (404) 778-6330 |
| 1558722132 | JAMILA KINDALL ATC Individual | Specialist/Technologist (Athletic Trainer) | 59 EXECUTIVE PARK S ATLANTA, GA 30329 (404) 778-6330 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1275152019, enumerated in the NPI registry as an "individual" on April 12, 2020
The provider is located at 59 Executive Park S Atlanta, Ga 30329 and the phone number is (404) 778-3350
The provider's speciality is Orthopaedic Surgery with taxonomy code 207XX0005X with a focus in Sports Medicine
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
This NPI record was last updated on April 12, 2020. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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