Active NPI
Devon M Hall
- PACE Provider Organization
- Southest, DC
National Provider Identifier
1073376182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- PACE Provider Organization
- Practice address
- 3605 Minnesoda Ave.
Southest, DC 20019 - Phone
- (202) 717-7649
- NPI assigned
- Feb 1, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Specialties & licenses 2
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Attendant Care Provider | 3747A0650X | |||
| PACE Provider Organization | 251T00000X | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
3605 Minnesoda Ave.
Southest, DC 20019
Mailing address
6107 Welshire CT
Upper Marlboro, MD 20772-3838
Phone (202) 717-7649
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 1, 2024.
{
"created_epoch": "1706745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706745600000",
"number": "1073376182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6107 WELSHIRE CT",
"city": "UPPER MARLBORO",
"state": "MD",
"postal_code": "207723838",
"telephone_number": "202-717-7649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3605 MINNESODA AVE.",
"city": "SOUTHEST",
"state": "DC",
"postal_code": "20019",
"telephone_number": "202-717-7649"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "DEVON",
"middle_name": "M",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-01",
"last_updated": "2024-02-01",
"certification_date": "2024-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "3747A0650X",
"taxonomy_group": "",
"desc": "Technician, Attendant Care Provider",
"state": null,
"license": null,
"primary": false
},
{
"code": "251T00000X",
"taxonomy_group": "",
"desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.