Joe I Hall MD PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25882 Issued in TN

Legal business name

JOE I HALL MD PC

Practice address

107 J V Mangubat Drive
Waynesboro, TN 38485-2440

Phone

(931) 722-2800

Fax

(931) 722-9627

NPI assigned

Sep 5, 2006

Last updated

May 17, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sherri L Barber

Title

Credentialing

Phone

(931) 722-2800

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Hallmedical Clinic LLC

  • Family Medicine Physician
  • Waynesboro, TN
  • NPI 1952065328

  Sold to, 2021-10-01

  CMS change of ownership

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amy Elizabeth Burks, NP-C

  • Family Nurse Practitioner
  • Hohenwald, TN
  • NPI 1366819641
  NPD (past)
• Sandra Kilburn Daniel, ACNP-BC

  • Family Nurse Practitioner
  • Fayetteville, TN
  • NPI 1992947568
  NPD (past)
• Rachel Diane Davis

  • Family Nurse Practitioner
  • Waynesboro, TN
  • NPI 1740856186
  NPD (past)

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558051200000",
    "number": "1023110392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689",
            "city": "WAYNESBORO",
            "state": "TN",
            "postal_code": "384850689",
            "telephone_number": "931-722-2800",
            "fax_number": "931-722-9627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 J V MANGUBAT DRIVE",
            "city": "WAYNESBORO",
            "state": "TN",
            "postal_code": "384852440",
            "telephone_number": "931-722-2800",
            "fax_number": "931-722-9627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOE I HALL MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-05",
        "last_updated": "2019-05-17",
        "status": "A",
        "authorized_official_last_name": "BARBER",
        "authorized_official_first_name": "SHERRI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "931-722-2800"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "25882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "4060796",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3717844",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Hays
• Esmeraldo Diaz Herrera, MD
• Kyle Horton, PT, DPT
• Elizabeth Humphrey, PHARM.D.
• Jerry M Duren (Wayne County General Hospital Pharmacy)
• Robert R. Johannes, M.S. L.A.D.A.C.
• Carol Johnson, RN
• Candice Suzanne Johnston, PTA
• Judy Lynn Jones, FNP
• Barbara Jordahl, MS

• Family Medicine Physician in Waynesboro, TN
• Providers in Waynesboro, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.