Active NPI
Richard Hall, P.A.
- Family Medicine Physician
- Salem, OR
National Provider Identifier
1093759052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- PA169367
- Practice address
- 1155 Mission St SE
Salem, OR 97302-6228 - Phone
- (503) 399-2424
- Fax
- (503) 375-7429
- NPI assigned
- Jun 16, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | PA169367 | OR | Primary |
Addresses
Primary practice location
1155 Mission St SE
Salem, OR 97302-6228
Mailing address
PO Box 8100
Salem, OR 97303-0900
Phone (503) 399-2424
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 196367 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA169367 | OR | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263772800000",
"number": "1093759052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8100",
"city": "SALEM",
"state": "OR",
"postal_code": "973030900",
"telephone_number": "503-399-2424",
"fax_number": "503-375-7429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1155 MISSION ST SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973026228",
"telephone_number": "503-399-2424",
"fax_number": "503-375-7429"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "RICHARD",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-16",
"last_updated": "2010-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "PA169367",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "196367",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.