Active NPI
David Hall, FNP
- Family Nurse Practitioner
- Corvallis, OR
National Provider Identifier
1124161344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 200150069NP
- Practice address
- 3600 NW Samaritan Dr
Corvallis, OR 97330-5472 - Phone
- (541) 768-5111
- NPI assigned
- Feb 15, 2007
- Last updated
- Mar 7, 2023
- 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 Nurse Practitioner | 363LF0000X | 200150069NP | OR | Primary |
Addresses
Primary practice location
3600 NW Samaritan Dr
Corvallis, OR 97330-5472
Mailing address
PO Box 1188
Corvallis, OR 97339-1188
Other practice location 1
4600 Evergreen Place SE
Suite 200
Albany, OR 97322-6182
Phone (541) 812-5020
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dhall124096@samhealth.direct-ci.com |
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
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Health Care LLC | Past | Accepting new patients |
Interoperability endpoints
- dhall124096@samhealth.direct-ci.com
Organizations & group practices 1
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.
-
dba Get A Flu Shot.com
- Adult Health Nurse Practitioner
- West Linn, OR
- NPI 1528244282
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1124161344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1188",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973391188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 NW SAMARITAN DR",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973305472",
"telephone_number": "541-768-5111"
}
],
"practiceLocations": [
{
"address_1": "4600 Evergreen Place SE",
"address_2": "Suite 200",
"address_purpose": "LOCATION",
"city": "Albany",
"state": "OR",
"postal_code": "973226182",
"country_code": "US",
"telephone_number": "541-812-5020",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HALL",
"first_name": "DAVID",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-15",
"last_updated": "2023-03-07",
"certification_date": "2022-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OR",
"license": "200150069NP",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dhall124096@samhealth.direct-ci.com",
"affiliation": "N",
"address_1": "3600 NW Samaritan Dr",
"city": "Corvallis",
"state": "OR",
"country_code": "US",
"postal_code": "973305472",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Corvallis, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.