Jhon R Hall, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

M5446 Issued in ID

Practice address

13176 W Persimmon Lane
Boise, ID 83713

Phone

(208) 939-8640

Fax

(208) 939-1892

NPI assigned

Nov 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ID

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Jan Deblieck MD PA

  dba DeBlieck Dermatology

  • Dermatology Physician
  • Boise, ID
  • NPI 1497960983
  NPD (past)

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225107386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13176 W PERSIMMON LANE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83713",
            "telephone_number": "208-939-8640",
            "fax_number": "208-939-1892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13176 W PERSIMMON LANE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83713",
            "telephone_number": "208-939-8640",
            "fax_number": "208-939-1892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "JHON",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "ID",
            "license": "M5446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "23812",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "82800",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory N Hall, LPC, NCC
• Jacob Richard Hall
• Jeffrey Timothy Hall, M.D.
• Jessica Hall, NP
• Jessica Ruth Hall
• Katharine M Hall, NP
• Lynda Hall, LMSW
• Olivia Brianne Hall
• Rachael Lee Hall, L.P.C.
• Rebekah E Hall, PSYD

• Dermatology Physician in Boise, ID
• Providers in Boise, ID by specialty
• Dermatology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.