Individual provider Active NPI

Ryan Hall

  • Psychiatry Physician
  • Charleston, SC
National Provider Identifier
1194568139
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MMD.92353 Issued in SC
Practice address
67 President St # 862
Charleston, SC 29425-5712
Phone
(843) 792-0192
NPI assigned
Jun 17, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MMD.92353 SC Primary

Addresses

Primary practice location

67 President St # 862
Charleston, SC 29425-5712

Mailing address

67 President St # 862
Charleston, SC 29425-5712
Phone (843) 792-0192

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241003004262 SC Order and Referring Only - PsychiatryPractitioner - Psychiatry 9931630753

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MMD.92353SCMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1194568139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 PRESIDENT ST # 862",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294255712",
            "telephone_number": "843-792-0192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 PRESIDENT ST # 862",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294255712",
            "telephone_number": "843-792-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "RYAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "MMD.92353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.