Individual provider Active NPI

Nicholas Hall, DO

  • Student in an Organized Health Care Education/Training Program
  • Flint, MI
National Provider Identifier
1013652767
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
5101027698 Issued in MI
Practice address
G3230 Beecher Rd Ste 2
Flint, MI 48532-3604
Phone
(810) 342-5800
Fax
(810) 342-5810
NPI assigned
Apr 27, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5151015489 MI
General Practice Physician 208D00000X 5101027698 MI
Student in an Organized Health Care Education/Training Program 390200000X 5101027698 MI Primary

Addresses

Primary practice location

G3230 Beecher Rd Ste 2
Flint, MI 48532-3604

Mailing address

G3230 Beecher Rd Ste 2
Flint, MI 48532-3604
Phone (810) 342-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220607003302 MI Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 7618355439

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101027698MIMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1651017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1013652767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "G3230 BEECHER RD STE 2",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323604",
            "telephone_number": "810-342-5800",
            "fax_number": "810-342-5810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "G3230 BEECHER RD STE 2",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323604",
            "telephone_number": "810-342-5800",
            "fax_number": "810-342-5810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-27",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5151015489",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "5101027698",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "5101027698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.