Individual provider Active NPI

Robert Clifford Hall, PT

  • Physical Therapist
  • Longview, TX
National Provider Identifier
1093742835
Registry record updated Apr 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1057024 Issued in TX
Practice address
409 N 6TH St
Longview, TX 75601-6536
Phone
(903) 758-2746
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1057024 TX Primary

Addresses

Primary practice location

409 N 6TH St
Longview, TX 75601-6536

Mailing address

323 E Hawkins Pkwy
Ste a
Longview, TX 75605-7905
Phone (903) 758-2746

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120627000741 TX Practitioner - Physical Therapist in Private Practice 2769647619 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1057024TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Longview Orthopaedic Clinic Association CurrentSince Jun 1, 2012 Accepting new patients

Locations

409 N 6th St
Longview, TX 75601
Phone (903) 315-5520

323 E Hawkins Pkwy
Ste A
Longview, TX 75605
Phone (903) 758-2746

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492387200000",
    "number": "1093742835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 E HAWKINS PKWY",
            "address_2": "STE A",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756057905",
            "telephone_number": "903-758-2746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 N 6TH ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756016536",
            "telephone_number": "903-758-2746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "ROBERT",
        "middle_name": "CLIFFORD",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2017-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1057024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.