Individual provider Active NPI

Russell D Hall, M.D.

  • Internal Medicine Physician
  • Greenwood, SC
National Provider Identifier
1265429492
Registry record updated Feb 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
SC16514 Issued in SC
Practice address
104 Liner Dr
Greenwood, SC 29646-2310
Phone
(864) 227-1115
Fax
(864) 227-2046
NPI assigned
Oct 3, 2005
Last updated
Feb 4, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X SC16514 SC Primary

Addresses

Primary practice location

104 Liner Dr
Greenwood, SC 29646-2310

Mailing address

104 Liner Dr
Greenwood, SC 29646-2310
Phone (864) 227-1115

Other identifiers 1

IdentifierTypeStateIssuer
TL6268MedicaidSC

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
I20100128000199 SC Practitioner - Internal Medicine 2769524867 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of North Carolina at Chapel Hill School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Self Medical GroupGroup PAC ID 6002953916, 393 clinicians
Self Regional HealthcareGroup PAC ID 4082527742, 159 clinicians

Practice addresses (Care Compare)

102 Gregor Mendel Cir
Greenwood, SC 29646-2315
Phone (864) 229-2663

102 Katie CT
Greenwood, SC 29646-4068
Phone (864) 725-7770

1033 Edgefield St
Greenwood, SC 29646-3205
Phone (864) 227-3908

104 Liner Dr
Greenwood, SC 29646-2310
Phone (864) 227-1115

104 Wells Ave
Greenwood, SC 29646-3837

105 Vinecrest CT
Greenwood, SC 29646-8031

109 Liner Dr
Greenwood, SC 29646-2311
Phone (864) 227-6401

1123 Spring St
Greenwood, SC 29646-3833
Phone (864) 450-9036

1325 Spring St
Greenwood, SC 29646-3860
Phone (864) 725-4111

1325 Spring St
Greenwood, SC 29646-3875

138 Wells Ave
Greenwood, SC 29646-3837
Phone (864) 725-4138

1506 Spring St
Greenwood, SC 29646-4071
Phone (864) 725-7900

160 Academy Ave
Greenwood, SC 29646-3808
Phone (864) 223-8090

298 Commerce Dr
Newberry, SC 29108-2953
Phone (803) 321-3232

305 W Alexander Ave
A
Greenwood, SC 29646-4009
Phone (864) 725-4111

410 Epting Ave
Greenwood, SC 29646-4040
Phone (864) 725-6042

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16514SCMDClinical Social Worker
SC16514SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Self Regional Healthcare Current Accepting new patients
Self Medical Group CurrentSince Apr 27, 2010 Accepting new patients
Piedmont Internal Med PA Internal Medicine Current Accepting new patients
Self Regional Healthcare Internal Medicine CurrentSince Oct 1, 2025 Accepting new patients
Self Medical Group CurrentSince Apr 27, 2010 Accepting new patients
Self Medical Group Current Accepting new patients
Self Regional Healthcare Past Accepting new patients
Self Regional Healthcare Past Accepting new patients

Locations

75 Remittance Dr
Dept 6764
Chicago, IL 60675

75 Remittance Dr
Dept 6793
Chicago, IL 60675

75 Remittance Dr
Dept 6875
Chicago, IL 60675

104 Liner Dr
Greenwood, SC 29646
Phone (864) 227-1115

1325 Spring St
Greenwood, SC 29646
Phone (864) 227-4111

155 Academy Ave
Greenwood, SC 29646
Phone (864) 725-4865

2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866

Interoperability endpoints

  • Direct secure messaging: rhall127289@selfregional.direct-ci.net

Organizations & group practices 8

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296777600000",
    "number": "1265429492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 LINER DR",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296462310",
            "telephone_number": "864-227-1115",
            "fax_number": "864-227-2046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 LINER DR",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296462310",
            "telephone_number": "864-227-1115",
            "fax_number": "864-227-2046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "RUSSELL",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2011-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "SC16514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TL6268",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.