Individual provider Active NPI

Mark Adam Hall, P.T., OMT, ATC, CSCS

  • Physical Therapist
  • Bedford, NH
National Provider Identifier
1184773251
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2116 Issued in NH
Practice address
82 Palomino LN Ste 501
Bedford, NH 03110-6448
Phone
(603) 627-6381
NPI assigned
Jan 9, 2007
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2116 NH Primary

Addresses

Primary practice location

82 Palomino LN Ste 501
Bedford, NH 03110-6448

Mailing address

82 Palomino LN Ste 501
Bedford, NH 03110-6448
Phone (603) 627-6381

Other practice location 1

72 S River Rd Ste 202
Bedford, NH 03110-6759
Phone (603) 668-2300

Other practice location 2

72 S River Rd Ste 202
Bedford, NH 03110-6759
Phone (603) 668-2300

Other identifiers 7

IdentifierTypeStateIssuer
9406774OtherNHPHCS
0653546OtherNHCIGNA
1101386OtherNHAETNA
5656604OtherNHFIRST HEALTH, HCVM
AA37427OtherNHHARVARD PILGRIM
08Y008490NH01OtherNHANTHEM
30393905MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050815000803 NH Practitioner - Physical Therapist in Private Practice 4284664798

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Trainingzone Inc. Physical Therapist Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1184773251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 PALOMINO LN STE 501",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031106448",
            "telephone_number": "603-627-6381",
            "fax_number": "603-627-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 PALOMINO LN STE 501",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031106448",
            "telephone_number": "603-627-6381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "72 S River Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Bedford",
            "state": "NH",
            "postal_code": "031106759",
            "country_code": "US",
            "telephone_number": "603-668-2300",
            "fax_number": "603-668-2533",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "72 S River Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Bedford",
            "state": "NH",
            "postal_code": "031106759",
            "country_code": "US",
            "telephone_number": "603-668-2300",
            "fax_number": "603-668-2533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALL",
        "first_name": "MARK",
        "middle_name": "ADAM",
        "name_prefix": "Mr.",
        "credential": "P.T., OMT, ATC, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "2116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "9406774",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0653546",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1101386",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH, HCVM",
            "identifier": "5656604",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "AA37427",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "08Y008490NH01",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30393905",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.