Individual provider Active NPI

Patrick R Hall, MD

  • Internal Medicine Physician
  • Lawrenceville, GA
National Provider Identifier
1083970610
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
074525 Issued in GA
Practice address
750 S Perry St FL 2
Lawrenceville, GA 30046-3233
Phone
(678) 377-4080
NPI assigned
Apr 9, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 074525 GA Primary

Addresses

Primary practice location

750 S Perry St FL 2
Lawrenceville, GA 30046-3233

Mailing address

3495 Piedmont Rd NE
Nine Piedmont Center
Atlanta, GA 30305-1717
Phone (404) 364-7070

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE) Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160520000952 GA Practitioner - Internal Medicine 1355630914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of South Carolina School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Southeast Permanente Medical GroupGroup PAC ID 6204829013, 823 clinicians

Practice addresses (Care Compare)

101 Banks Sta
Fayetteville, GA 30214-7507
Phone (404) 379-6148

1175 Cascade Pkwy SW
Atlanta, GA 30311-3090
Phone (404) 505-4012

2400 Mount Zion Pkwy
Jonesboro, GA 30236-2500
Phone (770) 603-3685

2470 Mount Zion Pkwy
BLDG 200
Jonesboro, GA 30236-2500
Phone (770) 527-9031

3495 Piedmont Rd NE
Atlanta, GA 30305-1729
Phone (404) 364-7206

3650 Steve Reynolds Blvd
Duluth, GA 30096-4506
Phone (770) 931-6026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Southeast Permanente Medical Group Internal Medicine CurrentSince Mar 12, 2016 Accepting new patients
Kaiser Permanente PastSince Jan 21, 2022 Accepting new patients

Locations

1745 Peachtree St NE
Ste U
Atlanta, GA 30309
Phone (404) 545-5161

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

201 W Ponce de Leon Ave
Ste A
Decatur, GA 30030
Phone (404) 687-7700

20 Glenlake Pkwy
Sandy Springs, GA 30328
Phone (770) 677-6247

Organizations & group practices 2

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": "1333929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1083970610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 PIEDMONT RD NE",
            "address_2": "NINE PIEDMONT CENTER",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051717",
            "telephone_number": "404-364-7070",
            "fax_number": "404-525-2957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 S PERRY ST FL 2",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463233",
            "telephone_number": "678-377-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "PATRICK",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-09",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "074525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "201 W Ponce De Leon Ave Ste A",
            "city": "Decatur",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300303260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.