Individual provider Active NPI

Kristin Kirby Hall, PA-C

  • Physician Assistant
  • Westport, CT
National Provider Identifier
1265716369
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3861 Issued in CT
Practice address
156 Kings Hwy Norby Suite 3
Westport, CT 06880-2400
Phone
(203) 227-3674
Fax
(203) 454-5639
NPI assigned
Oct 6, 2011
Last updated
Feb 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110003681 VA
Physician Assistant 363A00000X 017515 NY
Physician Assistant 363A00000X 3861 CT Primary

Addresses

Primary practice location

156 Kings Hwy Norby Suite 3
Westport, CT 06880-2400

Mailing address

156 Kings Hwy Norby Suite 3
Westport, CT 06880-2400
Phone (203) 227-3674

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190314002434 CT Practitioner - Physician Assistant 9234458480 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3861CTMDPhysician Assistant
017515NYMDPhysician Assistant
0110003681VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center Inc CurrentSince Oct 23, 2017 Accepting new patients
Community Health Center Inc CurrentSince Oct 23, 2017 Accepting new patients

Locations

575 Main St
Ste 2
Middletown, CT 06457

Organizations & group practices 2

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": "1317859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1265716369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 KINGS HWY NORBY SUITE 3",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068802400",
            "telephone_number": "203-227-3674",
            "fax_number": "203-454-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 KINGS HWY NORBY SUITE 3",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068802400",
            "telephone_number": "203-227-3674",
            "fax_number": "203-454-5639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "KRISTIN",
        "middle_name": "KIRBY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-06",
        "last_updated": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110003681",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017515",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "3861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westport, CT

Sources for this page

Verify at the official NPI Registry.