Individual provider Active NPI

David Chadwick Hall II, D.C (CHIROPRACTOR)

  • Chiropractor
  • Southaven, MS
National Provider Identifier
1275565285
Registry record updated Feb 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1098 Issued in MS
Practice address
1134 Church Rd W
Southaven, MS 38671-7144
Phone
(662) 393-4848
Fax
(662) 393-4858
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1098 MS Primary
Chiropractor 111N00000X 1776 TN

Addresses

Primary practice location

1134 Church Rd W
Southaven, MS 38671-7144

Mailing address

PO Box 175
Nesbit, MS 38651-0175
Phone (662) 393-4848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141230001935 MS Practitioner - Chiropractic 7012911688 Reassigns benefits to 1 organization
Practice locations: Southaven, MS

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2000
Medicare assignment
May accept Medicare assignment
Group practices
Desoto County Chiropractic IncGroup PAC ID 4981918463, 2 clinicians

Practice addresses (Care Compare)

1134 Church Rd W
Southaven, MS 38671-7144
Phone (662) 393-4848

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1776TNMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Desoto County Chiropractic, Inc. CurrentSince May 26, 2015 Accepting new patients
Tunica Chiropractic, Inc. Chiropractor Past Accepting new patients

Locations

1134 Church Rd W
Southaven, MS 38671
Phone (662) 393-4848

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362009600000",
    "number": "1275565285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 175",
            "city": "NESBIT",
            "state": "MS",
            "postal_code": "386510175",
            "telephone_number": "662-393-4848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1134 CHURCH RD W",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386717144",
            "telephone_number": "662-393-4848",
            "fax_number": "662-393-4858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "DAVID",
        "middle_name": "CHADWICK",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "D.C (CHIROPRACTOR)",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2013-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "1098",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "1776",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.