Amanda Brooke Hall, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

Q1988 Issued in TX

Practice address

9701 Harmon Rd Ste 141
Fort Worth, TX 76177-7521

Phone

(817) 306-5630

Fax

(817) 306-5631

NPI assigned

Jun 21, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Previously, effective Aug 12, 2024 through Aug 12, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1403308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1154736833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 TOWNE CT",
            "city": "SAGINAW",
            "state": "TX",
            "postal_code": "761791280",
            "telephone_number": "817-306-5630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9701 HARMON RD STE 141",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761777521",
            "telephone_number": "817-306-5630",
            "fax_number": "817-306-5631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "AMANDA",
        "middle_name": "BROOKE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-21",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "BP10044541",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q1988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "350777401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Esther Nicory Haley, FNP-C
• Felecia Haley
• Raj Raghunath Halker, M.D.
• Shuniqua Halkmon
• Anita H. Hall Vincent, O.D.
• Brittany Hall, PH.D.
• Christopher Paul Hall, ATC, LAT
• Daniella G Hall, PA-C
• Edwin Darrell Hall, OTR, CHT
• Jacob Spencer Hall, PHARMD

• Family Medicine Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.