Individual provider Active NPI

Alice Fay Hall

  • Gerontology Nurse Practitioner
  • Columbia, MO
National Provider Identifier
1033733647
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
2025005129 Issued in MO
Practice address
One Hospital Dr
Columbia, MO 65212-0001
Phone
(573) 882-8454
Fax
(573) 882-6054
NPI assigned
May 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 2025005129 MO
Family Nurse Practitioner 363LF0000X 239719 AZ
Gerontology Nurse Practitioner 363LG0600X 2025005129 MO Primary

Addresses

Primary practice location

One Hospital Dr
Columbia, MO 65212-0001

Mailing address

PO Box 843966
Kansas City, MO 64184-3966
Phone (573) 884-3300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address alice.hall.1@1576.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200820000160 AZ Practitioner - Nurse Practitioner 0749606846 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1625 N Campbell Ave
Tucson, AZ 85719-4330

Hospital & facility affiliations

  • Banner - University Medical Center Tucson Campus Hospital, Tucson, AZ, CCN 030064

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2025005129MOMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Community Physician PC CurrentSince Aug 1, 2020 Accepting new patients
Arizona Community Physicians PC Nurse Practitioner CurrentSince Aug 1, 2020 Accepting new patients
Northwest Allied Physicians, LLC CurrentSince Sep 1, 2022 Accepting new patients
Northwest Allied Physicians LLC CurrentSince Sep 1, 2022 Accepting new patients

Locations

1551 E Tangerine Rd
Oro Valley, AZ 85755
Phone (520) 901-3500

6200 N La Cholla Blvd
Tucson, AZ 85741
Phone (520) 229-2657

2055 W Hospital Dr
Tucson, AZ 85704
Phone (520) 547-5725

5055 E Broadway Blvd
Ste A100
Tucson, AZ 85711
Phone (520) 327-0460

6320 N La Cholla Blvd
Ste 300
Tucson, AZ 85741
Phone (520) 545-0953

4001 E Sunrise Dr
Ste 161
Tucson, AZ 85718
Phone (520) 232-5280

7395 E Tanque Verde Rd
Tucson, AZ 85715
Phone (520) 355-2900

8333 N Silverbell Rd
Ste 161
Tucson, AZ 85743
Phone (520) 202-7770

6200 N La Cholla Blvd
Ste 206B
Tucson, AZ 85741

Interoperability endpoints

  • Direct secure messaging: alice.hall.1@1576.direct.athenahealth.com

Organizations & group practices 4

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

Hospital & facility affiliations 2

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": "1590883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1033733647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843966",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641843966",
            "telephone_number": "573-884-3300",
            "fax_number": "573-884-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE HOSPITAL DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652120001",
            "telephone_number": "573-882-8454",
            "fax_number": "573-882-6054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "ALICE",
        "middle_name": "FAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-31",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MO",
            "license": "2025005129",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "239719",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2025005129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alice.hall.1@1576.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "6320 N La Cholla Blvd Ste 300",
            "city": "Tucson",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "857413552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.