Active NPI
Anthony Bernard Hall, PHD OD
- Optometrist
- Escanaba, MI
National Provider Identifier
1215020615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901003761
- Practice address
- 814 Ludington St
Family Eye Care
Escanaba, MI 49829-3828 - Phone
- (906) 786-6573
- Fax
- (906) 786-1174
- NPI assigned
- Sep 30, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901003761 | MI | Primary |
Addresses
Primary practice location
814 Ludington St
Family Eye Care
Escanaba, MI 49829-3828
Mailing address
814 Ludington St
Escanaba, MI 49829-3828
Phone (906) 786-6573
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 900B110450 | Other | MI | BLUE CROSS |
| 4074414 | Medicaid | MI |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1215020615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "814 LUDINGTON ST",
"city": "ESCANABA",
"state": "MI",
"postal_code": "498293828",
"telephone_number": "906-786-6573",
"fax_number": "906-786-1174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "814 LUDINGTON ST",
"address_2": "FAMILY EYE CARE",
"city": "ESCANABA",
"state": "MI",
"postal_code": "498293828",
"telephone_number": "906-786-6573",
"fax_number": "906-786-1174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "ANTHONY",
"middle_name": "BERNARD",
"credential": "PHD OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-30",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901003761",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "900B110450",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4074414",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Escanaba, MI
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.