Timothy Wayne Hall, AGACNP-BC, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704199433 Issued in MI

Practice address

5900 Byron Center Ave SW
Wyoming, MI 49519-9606

Phone

(616) 252-7200

Fax

(616) 252-7830

NPI assigned

Jul 2, 2013

Sex

Male

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

Enrolled in MI

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advantage Health/Saint Mary'S Medical GroupGroup PAC ID 4082807961, 499 clinicians

Metropolitan HospitalGroup PAC ID 5597651836, 421 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Health Saint Mary'S Hospital, Grand Rapids, MI, CCN 230059
• University of Michigan Health - West Hospital, Wyoming, MI, CCN 230236

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: thall50602@direct.metrohealth.net
• Direct secure messaging: thall3867982@direct.trinity-health.org
• Direct secure messaging: thall176104@direct.covenanthealthcare.com

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.

• Advantage Health/Saint Mary'S Medical Group

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MI
  • NPI 1376862151
  Medicare reassignment Care Compare group NPD
• Metropolitan Hospital

  • Internal Medicine Physician
  • Wyoming, MI
  • NPI 1811937519
  Medicare reassignment Care Compare group NPD
• Epi PC

  • Emergency Medicine Physician
  • Holland, MI
  • NPI 1225082266
  Medicare reassignment NPD
• Advantage Health Saint Mary'S Medical Group

  • Orthopaedic Surgery Physician
  • Byron Center, MI
  • NPI 1003515008
  NPD
• Advantage Health Saint Mary'S Medical Group

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MI
  • NPI 1952340911
  NPD
• Metropolitan Hospital

  • Family Medicine Physician
  • Wyoming, MI
  • NPI 1114947538
  NPD (past)
• Metropolitan Hospital

  • Anatomic Pathology & Clinical Pathology Physician
  • Wyoming, MI
  • NPI 1336182542
  NPD (past)
• Metropolitan Hospital

  • General Acute Care Hospital
  • Wyoming, MI
  • NPI 1619923919
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Metropolitan Hospital

  • General Acute Care Hospital
  • Wyoming, MI
  • NPI 1619923919
  Care Compare affiliation
• Saint Mary'S Health Services

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1639111057
  Care Compare affiliation

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

{
    "created_epoch": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1154761336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "address_2": "MEDICAL ADMINISTRATION",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199606",
            "telephone_number": "616-252-3243",
            "fax_number": "616-252-0260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199606",
            "telephone_number": "616-252-7200",
            "fax_number": "616-252-7830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "TIMOTHY",
        "middle_name": "WAYNE",
        "credential": "AGACNP-BC, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-02",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704199433",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704199433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154761336",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sumaiya Haider, DO
• Danielle Hainer
• Shelby Halas
• Emily Suzanne Haligowski, FNP
• Colton Kent Hall, DO
• Audrie Ann Haller I
• Halliday Health Solutions, L.L.C.
• Michael Richard Halliday, DC
• Ryan Daniel Hamby, DO
• John W Hamersma, M.D.

• Family Nurse Practitioner in Wyoming, MI
• Providers in Wyoming, MI by specialty
• Family Nurse Practitioner in Michigan

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.