Individual provider Active NPI

Deana Demare Hally

  • Health & Wellness Coach
  • Fairfax Station, VA
National Provider Identifier
1003523101
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health & Wellness CoachTaxonomy code 171400000X
Practice address
5945 Innisvale Dr
Fairfax Station, VA 22039-1107
Phone
(703) 401-5745
NPI assigned
Oct 31, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health & Wellness Coach 171400000X VA Primary

Addresses

Primary practice location

5945 Innisvale Dr
Fairfax Station, VA 22039-1107

Mailing address

5945 Innisvale Dr
Fairfax Station, VA 22039-1107
Phone (703) 401-5745

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

NPI Registry JSON

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1003523101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5945 INNISVALE DR",
            "city": "FAIRFAX STATION",
            "state": "VA",
            "postal_code": "220391107",
            "telephone_number": "703-401-5745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5945 INNISVALE DR",
            "city": "FAIRFAX STATION",
            "state": "VA",
            "postal_code": "220391107",
            "telephone_number": "703-401-5745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMARE HALLY",
        "first_name": "DEANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-31",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax Station, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.