Individual provider Active NPI

Thomas Ethan Hall, DC

  • Chiropractor
  • Conway, AR
National Provider Identifier
1083400329
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
12441 Issued in AR
Practice address
675 Dave Ward Dr Ste 105
Conway, AR 72034-7168
Phone
(501) 504-6280
NPI assigned
Apr 15, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 12441 AR Primary

Addresses

Primary practice location

675 Dave Ward Dr Ste 105
Conway, AR 72034-7168

Mailing address

39 Rocky Rd
Greenbrier, AR 72058-9505

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250528001489 AR Practitioner - Chiropractic 0840719399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Beard Family Chiropractic LLCGroup PAC ID 4880812783, 3 clinicians

Practice addresses (Care Compare)

675 Dave Ward Dr
Suite 105
Conway, AR 72034-7083
Phone (501) 504-6280

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12441ARMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Beard Family Chiropractic, LLC Chiropractor CurrentSince Apr 20, 2025 Accepting new patients

Locations

675 Dave Ward Dr
Ste 105
Conway, AR 72034
Phone (501) 504-6280

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1744675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1083400329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 ROCKY RD",
            "city": "GREENBRIER",
            "state": "AR",
            "postal_code": "720589505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 DAVE WARD DR STE 105",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720347168",
            "telephone_number": "501-504-6280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "THOMAS",
        "middle_name": "ETHAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-15",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "12441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; 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.