Poala D. Prude-Hall, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301058586 Issued in MI

Practice address

505 N Clippert St
Lansing Urgent Care
Lansing, MI 48912-4701

Phone

(517) 333-9200

Fax

(517) 333-9201

NPI assigned

Nov 17, 2006

Last updated

Nov 15, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pprudehall13003@direct.hfhs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Medicare reassignment NPD
• Ambulatory United

  • Gynecology Physician
  • Greenville, MI
  • NPI 1104931492
  NPD (past)
• Lansing Urgent Care, PLC

  • Urgent Care Clinic/Center
  • Lansing, MI
  • NPI 1780987990
  NPD (past)

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384473600000",
    "number": "1093889503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 NORTH CLIPPERT",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "48912",
            "telephone_number": "517-333-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N CLIPPERT ST",
            "address_2": "LANSING URGENT CARE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489124701",
            "telephone_number": "517-333-9200",
            "fax_number": "517-333-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUDE-HALL",
        "first_name": "POALA",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2013-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301058586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Promissa Personalized Care Services LLC
• Prosthetic Center, Inc.
• Protherapy
• Michael Provenzano
• Providence Family Chiropractic P.L.L.C.
• Angela Pruitt, CHW
• Pso Laboratory LLC
• Psychological Associates in Rehabilitation PC
• Psychological Associates in Rehabilitation PC (PAR Rehab Services)
• Psychological Wellness, PLC

• Family Medicine Physician in Lansing, MI
• Providers in Lansing, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2013; 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.

Verify at the official NPI Registry.