Richard Alan Hall, DC
Individual provider Active NPI Chiropractor · Peconic, NY
NPI 1043370430 · NPPES record last updated Jul 10, 2012
Key facts
- NPI
- 1043370430
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- X2373 (NY)
- Practice address
- 35650 County Rd
Peconic, NY 11958 - Phone
- (631) 765-9520
- Fax
- (631) 765-9520
- NPI assigned
- Dec 8, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Other, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
35650 County Rd
Suite 48
Peconic, NY 11958-1441
Phone (631) 765-9520
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040917000305 | NY | Practitioner - Chiropractic | 2062480106 | Practice locations: Peconic, NY |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X2373 | NY | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X2373 | NY | Yes |
Addresses
Primary practice location
35650 County Rd
Peconic, NY 11958
Mailing address
PO Box 568
Southold, NY 11971-0568
Phone (631) 765-9520
NPI Registry JSON
{
"created_epoch": "1165536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341878400000",
"number": "1043370430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 568",
"city": "SOUTHOLD",
"state": "NY",
"postal_code": "119710568",
"telephone_number": "631-765-9520",
"fax_number": "631-765-9520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35650 COUNTY RD",
"city": "PECONIC",
"state": "NY",
"postal_code": "11958",
"telephone_number": "631-765-9520",
"fax_number": "631-765-9520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "RICHARD",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-08",
"last_updated": "2012-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X2373",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peconic, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.