Individual provider Active NPI

Dawn Chandrell Hall

  • Psychiatric/Mental Health Nurse Practitioner
  • Knightdale, NC
National Provider Identifier
1063262202
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2023153408 Issued in NC
Practice address
1436 Silver Valley Dr
Knightdale, NC 27545-7557
Phone
(716) 907-8377
NPI assigned
Mar 22, 2024
Last updated
Mar 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2023153408 NC Primary

Addresses

Primary practice location

1436 Silver Valley Dr
Knightdale, NC 27545-7557

Mailing address

1436 Silver Valley Dr
Knightdale, NC 27545-7557
Phone (716) 907-8377

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20241021001122 NC Practitioner - Nurse Practitioner 1052843687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Garner Behavioral Hospital LLCGroup PAC ID 4981072238, 23 clinicians

Practice addresses (Care Compare)

3200 Waterfield Dr
Garner, NC 27529-7727
Phone (919) 502-1187

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2023153408NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Garner Behavioral Hospital, LLC CurrentSince Jul 18, 2024 Accepting new patients

Locations

3200 Waterfield Dr
Garner, NC 27529
Phone (919) 502-1187

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1711065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1063262202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1436 SILVER VALLEY DR",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275457557",
            "telephone_number": "716-907-8377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1436 SILVER VALLEY DR",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275457557",
            "telephone_number": "716-907-8377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "DAWN",
        "middle_name": "CHANDRELL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-22",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "2023153408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knightdale, NC

Sources for this page

Verify at the official NPI Registry.