Individual provider Active NPI

Rasheeda Crowell Hall, M.D.

  • Family Medicine Physician
  • Liberty, MS
National Provider Identifier
1114280591
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
24033 Issued in MS
Practice address
102 W Freedom Dr
Liberty, MS 39645-7295
Phone
(601) 657-8091
Fax
(833) 314-0337
NPI assigned
Jun 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 24033 MS Primary

Addresses

Primary practice location

102 W Freedom Dr
Liberty, MS 39645-7295

Mailing address

PO Box 1729
Hattiesburg, MS 39403-1729
Phone (601) 545-8700

Other practice location 1

1014 Rose St Ste A
Prentiss, MS 39474-5271
Phone (601) 792-2200

Other practice location 2

100 Highway 535
Seminary, MS 39479
Phone (601) 722-3208

Other identifiers 3

IdentifierTypeStateIssuer
598485YJ69OtherMSMS MEDICARE
00028059MedicaidMS
14200819OtherMSCAQH - MS

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
I20171005001983 MS Practitioner - Family Practice 0345483004 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Mississippi School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amite County Medical Services Inc 8 clinicians

Practice addresses (Care Compare)

102 W Freedom Dr
Liberty, MS 39645-7295
Phone (601) 657-4326

Hospital & facility affiliations

  • Heart of Hospice, LLC - Southern Hospice, Hattiesburg, MS, CCN 251706

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24033MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sumrall Family Health Center Current Accepting new patients
Amite County Medical Services, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Amite County Medical Services, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Forest General Dba Highland Community Hospital CurrentSince Aug 13, 2017 Accepting new patients
Forrest County General Hospital Current Accepting new patients
New Augusta Family Health Center CurrentSince Aug 12, 2019 Accepting new patients
Hall Health Current Accepting new patients
Hattiesburg Community Dental Center CurrentSince Aug 12, 2019 Accepting new patients
Pioneer Health Care , LLC CurrentSince Jul 1, 2019 Accepting new patients
Forrest County General Hospital CurrentSince Aug 13, 2017 Accepting new patients
Conx Care Corporation Family Medicine Past Accepting new patients

Locations

44 Brooklyn Janice Rd
Brooklyn, MS 39425
Phone (601) 582-1188

15 Keystone Dr
Ste E
Hattiesburg, MS 39402
Phone (601) 606-6326

300 Cahal St
Hattiesburg, MS 39401
Phone (601) 582-9157

6051 U S Highway 49
Hattiesburg, MS 39401
Phone (601) 288-2690

1014 Rose St
Ste A
Prentiss, MS 39474
Phone (601) 792-2200

100 Highway 535
Seminary, MS 39479
Phone (601) 722-3208

1016 Highway 42
Sumrall, MS 39482
Phone (601) 758-4214

Interoperability endpoints

  • Direct secure messaging: rasheeda.hall.1@22116.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/8276/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/22116/brand/1/csg/1/fhir/r4

Organizations & group practices 11

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.

Hospital & facility affiliations 1

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": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1114280591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1729",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394031729",
            "telephone_number": "601-545-8700",
            "fax_number": "601-450-0794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W FREEDOM DR",
            "city": "LIBERTY",
            "state": "MS",
            "postal_code": "396457295",
            "telephone_number": "601-657-8091",
            "fax_number": "833-314-0337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1014 Rose St Ste A",
            "address_purpose": "LOCATION",
            "city": "Prentiss",
            "state": "MS",
            "postal_code": "394745271",
            "country_code": "US",
            "telephone_number": "601-792-2200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Highway 535",
            "address_purpose": "LOCATION",
            "city": "Seminary",
            "state": "MS",
            "postal_code": "39479",
            "country_code": "US",
            "telephone_number": "601-722-3208",
            "fax_number": "601-722-3304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALL",
        "first_name": "RASHEEDA",
        "middle_name": "CROWELL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-20",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "24033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS MEDICARE",
            "identifier": "598485YJ69",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00028059",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH - MS",
            "identifier": "14200819",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, MS

Sources for this page

Verify at the official NPI Registry.