Active NPI
Carzadean Bernadette Hall, M.D.
- Adolescent Medicine (Internal Medicine) Physician
- Fayetteville, GA
National Provider Identifier
1003078296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adolescent Medicine (Internal Medicine) Physician
- License
- 034309
- Practice address
- 185 Franklin Farms Cir
Fayetteville, GA 30214-3361 - Phone
- (404) 216-0132
- NPI assigned
- Jun 28, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adolescent Medicine (Internal Medicine) Physician | 207RA0000X | 034309 | GA | Primary |
Addresses
Primary practice location
185 Franklin Farms Cir
Fayetteville, GA 30214-3361
Mailing address
185 Franklin Farms Cir
Fayetteville, GA 30214-3361
Phone (404) 216-0132
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 034309 | GA | MD | Adolescent Medicine (Internal Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214611200000",
"number": "1003078296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "185 FRANKLIN FARMS CIR",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302143361",
"telephone_number": "404-216-0132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "185 FRANKLIN FARMS CIR",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302143361",
"telephone_number": "404-216-0132"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "CARZADEAN",
"middle_name": "BERNADETTE",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-28",
"last_updated": "2008-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "207RA0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Adolescent Medicine",
"state": "GA",
"license": "034309",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.