Active NPI
Gregory Daryl Hall, PT
- Physical Therapist
- Bainbridge, GA
National Provider Identifier
1144569484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT010747
- Practice address
- 1500 E Shotwell St
Bainbridge, GA 39819-4256 - Phone
- (229) 246-3500
- Fax
- (229) 243-3342
- NPI assigned
- Feb 6, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT010747 | GA | Primary |
Addresses
Primary practice location
1500 E Shotwell St
Bainbridge, GA 39819-4256
Mailing address
1500 E Shotwell St
Bainbridge, GA 39819-4256
Phone (229) 246-3500
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT010747 | GA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360108800000",
"number": "1144569484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 E SHOTWELL ST",
"city": "BAINBRIDGE",
"state": "GA",
"postal_code": "398194256",
"telephone_number": "229-246-3500",
"fax_number": "229-243-3342"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 E SHOTWELL ST",
"city": "BAINBRIDGE",
"state": "GA",
"postal_code": "398194256",
"telephone_number": "229-246-3500",
"fax_number": "229-243-3342"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "GREGORY",
"middle_name": "DARYL",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-02-06",
"last_updated": "2013-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT010747",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bainbridge, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.