Individual provider Active NPI

Sydney Hall, PA-C

  • Medical Physician Assistant
  • Hickory, NC
National Provider Identifier
1124757349
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0010-14005 Issued in NC
Practice address
1501 Tate Blvd SE Ste 201
Hickory, NC 28602-1385
Phone
(828) 322-4140
NPI assigned
Jun 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0010-14005 NC Primary

Addresses

Primary practice location

1501 Tate Blvd SE Ste 201
Hickory, NC 28602-1385

Mailing address

1258 11TH St NW
Hickory, NC 28601-2261
Phone (712) 460-3164

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240328002641 NC Practitioner - Physician Assistant 1557708336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Uwh of the Carolinas PLLCGroup PAC ID 0042448169, 329 clinicians

Practice addresses (Care Compare)

1501 Tate Blvd SE
Suite 201
Hickory, NC 28602-1385
Phone (828) 322-4140

1806 S Hawthorne Rd
Winston Salem, NC 27103-4014
Phone (336) 768-3632

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-14005NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Whap, PA Past Accepting new patients

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.

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": "1654473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1124757349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1258 11TH ST NW",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286012261",
            "telephone_number": "712-460-3164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 TATE BLVD SE STE 201",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286021385",
            "telephone_number": "828-322-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "SYDNEY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-06",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-14005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.