NPIMap

Individual provider Active NPI

Harolyn Hall

  • Nurse Practitioner
  • Boca Raton, FL
National Provider Identifier
1023494051
Registry record updated Jul 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
93111629 Issued in FL
Practice address
777 Glades Rd
Boca Raton, FL 33431-6424
Phone
(318) 547-0157
NPI assigned
Jul 31, 2015
Last updated
Jul 31, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 93111629 FL Primary

Addresses

Primary practice location

777 Glades Rd
Boca Raton, FL 33431-6424

Mailing address

777 Glades Rd
Boca Raton, FL 33431-6424
Phone (318) 547-0157

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151110001552 FL Practitioner - Nurse Practitioner 4284944919 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mobile Medical Operating Company LLCGroup PAC ID 1456747625, 11 clinicians
Grassam Family Chiropractic IncGroup PAC ID 7719019033, 2 clinicians

Practice addresses (Care Compare)

1840 SE Port St Lucie Blvd
Suite 1840
Port St Lucie, FL 34952-5545
Phone (772) 221-7620

516 Colorado Ave
Stuart, FL 34994-3014
Phone (772) 286-5433

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
93111629FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Medical Operating Company LLC CurrentSince Apr 1, 2022 Accepting new patients

Locations

4655 Salisbury Rd
Ste 110
Jacksonville, FL 32256
Phone (904) 570-9404

1840 SE Port St Lucie Blvd
Ste 1840
Port St Lucie, FL 34952
Phone (772) 221-7620

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438300800000",
    "number": "1023494051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 GLADES RD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316424",
            "telephone_number": "318-547-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 GLADES RD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316424",
            "telephone_number": "318-547-0157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "HAROLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-31",
        "last_updated": "2015-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "93111629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.