Individual provider Active NPI

Dalton Alexander Halm

  • Acute Care Nurse Practitioner
  • Granite City, IL
National Provider Identifier
1083403653
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
209032308 Issued in IL
Practice address
2100 Madison Ave
Granite City, IL 62040-4713
Phone
(619) 798-3000
NPI assigned
May 1, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 209032308 IL Primary

Addresses

Primary practice location

2100 Madison Ave
Granite City, IL 62040-4713

Mailing address

3703 Franklin Ave
Granite City, IL 62040-3911
Phone (618) 567-9130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20250716002949 IL Practitioner - Nurse Practitioner 4385159417 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment
Group practices
Ahs Il Medical Group LLC 46 clinicians

Practice addresses (Care Compare)

2100 Madison Ave
Granite City, IL 62040-4713
Phone (618) 798-3000

Hospital & facility affiliations

  • Gateway Regional Medical Center Hospital, Granite City, IL, CCN 140125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ahs Il Medical Group LLC CurrentSince May 17, 2025 Accepting new patients

Locations

1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870

2100 Madison Ave
Ste 301
Granite City, IL 62040

2100 Madison Ave
Granite City, IL 62040
Phone (618) 798-3000

8 Doctors Park Rd
Mount Vernon, IL 62864
Phone (618) 244-5500

Interoperability endpoints

  • Direct secure messaging: dhalm@yourcarecommunity.org

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1746057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1083403653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3703 FRANKLIN AVE",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620403911",
            "telephone_number": "618-567-9130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 MADISON AVE",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620404713",
            "telephone_number": "619-798-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALM",
        "first_name": "DALTON",
        "middle_name": "ALEXANDER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-01",
        "last_updated": "2025-05-01",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209032308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granite City, IL

Sources for this page

Verify at the official NPI Registry.