Individual provider Active NPI

Richard Alan Hall, DC

  • Chiropractor
  • Peconic, NY
National Provider Identifier
1043370430
Registry record updated Jul 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X2373 Issued in NY
Practice address
35650 County Rd
Peconic, NY 11958
Phone
(631) 765-9520
Fax
(631) 765-9520
NPI assigned
Dec 8, 2006
Last updated
Jul 10, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X2373 NY Primary

Addresses

Primary practice location

35650 County Rd
Peconic, NY 11958

Mailing address

PO Box 568
Southold, NY 11971-0568
Phone (631) 765-9520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040917000305 NY Practitioner - Chiropractic 2062480106 Practice locations: Peconic, NY

Care Compare profile

Medicare Care Compare
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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X2373NYMDChiropractor

NPI Registry JSON

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

{
    "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. Last updated by the provider on Jul 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.