Individual provider Active NPI

Terrence J Hall, M.D., PHD

  • Surgery Physician
  • Coquille, OR
National Provider Identifier
1003993064
Registry record updated Feb 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD175340 Issued in OR
Practice address
940 E 5TH Street
Coquille, OR 97423-1666
Phone
(541) 396-3101
Fax
(541) 396-1783
NPI assigned
Nov 1, 2006
Last updated
Feb 25, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036069953 IL
Surgery Physician 208600000X MD175340 OR Primary
Surgical Oncology Physician 2086X0206X 036-069953 IL

Addresses

Primary practice location

940 E 5TH Street
Coquille, OR 97423-1666

Mailing address

940 E 5TH Street
Coquille, OR 97423-1666
Phone (541) 396-3101

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MD175340ORMDSurgery Physician
036-069953ILMDSurgical Oncology Physician

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456358400000",
    "number": "1003993064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 E 5TH STREET",
            "city": "COQUILLE",
            "state": "OR",
            "postal_code": "974231666",
            "telephone_number": "541-396-3101",
            "fax_number": "541-396-1783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 E 5TH STREET",
            "city": "COQUILLE",
            "state": "OR",
            "postal_code": "974231666",
            "telephone_number": "541-396-3101",
            "fax_number": "541-396-1783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "TERRENCE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D., PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2016-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036069953",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD175340",
            "primary": true
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "IL",
            "license": "036-069953",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coquille, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2016; 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.