Individual provider Active NPI

Kyndall L Hall, PA

  • Physician Assistant
  • Tupelo, MS
National Provider Identifier
1104655851
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1211 S Gloster St
Tupelo, MS 38801-6546
Phone
(627) 676-4200
NPI assigned
Jul 31, 2024
Last updated
Aug 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 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
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1211 S Gloster St
Tupelo, MS 38801-6546

Mailing address

79 Madison Dr
Atmore, AL 36502-7631
Phone (251) 359-4229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20251027004725 MS Practitioner - Orthopedic Surgery 0244729697 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1211 S Gloster St
Suite a
Tupelo, MS 38801-6548
Phone (662) 767-4200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Orthopedic Group of Mississippi PLLC CurrentSince Oct 1, 2025 Accepting new patients
Specialty Orthopedic Group of Mississippi PLLC CurrentSince Oct 1, 2025 Accepting new patients

Locations

100 Baptist Memorial Cir
Ste 330
Oxford, MS 38655
Phone 6627674200 ext. 1057

723 Concordia Ave
Oxford, MS 38655

118 Highway 12 W
Starkville, MS 39759
Phone (662) 324-8070

1211 S Gloster St
Ste A
Tupelo, MS 38801
Phone (662) 377-3380

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1104655851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 MADISON DR",
            "city": "ATMORE",
            "state": "AL",
            "postal_code": "365027631",
            "telephone_number": "251-359-4229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 S GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016546",
            "telephone_number": "627-676-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "KYNDALL",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-31",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.