Individual provider Active NPI

Reginald W Hall, MD

  • Family Medicine Physician
  • Kansas City, MO
National Provider Identifier
1114968252
Registry record updated Apr 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
04-17241 Issued in KS
Practice address
6400 Prospect Ave
Suite 640
Kansas City, MO 64132-1100
Phone
(816) 523-7000
Fax
(816) 523-7095
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2012

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 04-17241 KS Primary

Addresses

Primary practice location

6400 Prospect Ave
Suite 640
Kansas City, MO 64132-1100

Mailing address

6400 Prospect Ave
Suite 640
Kansas City, MO 64132-1100
Phone (816) 523-7000

Other identifiers 2

IdentifierTypeStateIssuer
100092940IMedicaidKS
100092940KMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040302000353 KS Practitioner - Internal Medicine 6406743160 Reassigns benefits to 1 organization
I20070607000612 MO Practitioner - Internal Medicine 6406743160 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-17241KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Curana Health of Missouri-Kansas LLC Family Medicine CurrentSince Nov 7, 2018 Accepting new patients
Metropolitan Internal Medicine, LLC PastSince Feb 28, 2004 Accepting new patients

Locations

12724 State Line Rd
Leawood, KS 66209
Phone (913) 345-8808

9100 Park St
Lenexa, KS 66215
Phone (913) 888-1900

4600 College Blvd
Ste 103
Overland Park, KS 66211

6101 W 119th St
Overland Park, KS 66209
Phone (913) 345-9339

621 Carondelet Dr
Kansas City, MO 64114
Phone (816) 941-1300

2323 E 63rd St
Kansas City, MO 64130
Phone (816) 444-8161

1101 W Clay Rd
Versailles, MO 65084
Phone (573) 378-5312

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333497600000",
    "number": "1114968252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 PROSPECT AVE",
            "address_2": "SUITE 640",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641321100",
            "telephone_number": "816-523-7000",
            "fax_number": "816-523-7095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 PROSPECT AVE",
            "address_2": "SUITE 640",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641321100",
            "telephone_number": "816-523-7000",
            "fax_number": "816-523-7095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "REGINALD",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2012-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-17241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100092940I",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100092940K",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.