Active NPI
John Wayne Hall, MD
- Anesthesiology Physician
- Greenville, SC
National Provider Identifier
1083678411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 37034
- Practice address
- 67 Creekside Park CT
Greenville, SC 29615-4810 - Phone
- (864) 242-4602
- NPI assigned
- Apr 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 266626 | AL | |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 26626 | AL | |
| Anesthesiology Physician | 207L00000X | 37034 | SC | Primary |
Addresses
Primary practice location
67 Creekside Park CT
Greenville, SC 29615-4810
Mailing address
1 Independence PT
Suite 212
Greenville, SC 29615-4545
Phone (864) 797-6044
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 051556471 | Medicaid | AL | |
| 1083678411 | Other | AL | TRICARE |
| 51002019 | Other | AL | BLUE CROSS BLUE SHIELD AL |
| 554738662A | Medicaid | GA | |
| P00241498 | Other | AL | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37034 | SC | MD | Pharmacist |
| 266626 | AL | MD | Anesthesiology Physician |
| 26626 | AL | MD | Pain Medicine (Anesthesiology) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417737600000",
"number": "1083678411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 INDEPENDENCE PT",
"address_2": "SUITE 212",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296154545",
"telephone_number": "864-797-6044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "67 CREEKSIDE PARK CT",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296154810",
"telephone_number": "864-242-4602"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "JOHN",
"middle_name": "WAYNE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-13",
"last_updated": "2014-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "AL",
"license": "266626",
"primary": false
},
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "AL",
"license": "26626",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "SC",
"license": "37034",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "051556471",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "1083678411",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD AL",
"identifier": "51002019",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "554738662A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00241498",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.