Individual provider Active NPI

Danielle Hall

  • Family Nurse Practitioner
  • Olive Branch, MS
National Provider Identifier
1285454413
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
907921 Issued in MS
Practice address
4240 Bethel Rd Ste 201
Olive Branch, MS 38654-8737
Phone
(901) 763-0200
Fax
(901) 761-4002
NPI assigned
Oct 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 907921 MS Primary
Family Nurse Practitioner 363LF0000X 40218 TN
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

4240 Bethel Rd Ste 201
Olive Branch, MS 38654-8737

Mailing address

1211 Union Ave Ste 330
Memphis, TN 38104-6655

Other practice location 1

874 Union Ave
Memphis, TN 38103-3514
Phone (901) 448-6128

Other practice location 2

7460 Wolf River Blvd
Germantown, TN 38138-1760
Phone (901) 763-0200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20251122001102 MS Practitioner - Nurse Practitioner 8729570270 Reassigns benefits to 1 organization
I20251129000531 TN Practitioner - Nurse Practitioner 8729570270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Tennessee, HSC, College of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Specialty Physician Group LLCGroup PAC ID 9537291323, 101 clinicians

Practice addresses (Care Compare)

4240 Bethel Rd
Suite 201
Olive Branch, MS 38654-8737
Phone (901) 763-0200

7460 Wolf River Blvd
Germantown, TN 38138-1760
Phone (901) 763-0200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
40218TNMDPharmacist
907921MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Physician Group LLC Family CurrentSince Jan 11, 2026 Accepting new patients

Locations

4240 Bethel Rd
Ste 201
Olive Branch, MS 38654

4250 Bethel Rd
Fl 5
Olive Branch, MS 38654
Phone (662) 932-9544

7460 Wolf River Blvd
Memphis, TN 38138
Phone (901) 516-6792

1211 Union Ave
Ste 330
Memphis, TN 38104
Phone (901) 478-0954

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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": "1728864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1285454413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE STE 330",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4240 BETHEL RD STE 201",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386548737",
            "telephone_number": "901-763-0200",
            "fax_number": "901-761-4002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "874 Union Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381033514",
            "country_code": "US",
            "telephone_number": "901-448-6128",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7460 Wolf River Blvd",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381381760",
            "country_code": "US",
            "telephone_number": "901-763-0200",
            "fax_number": "901-761-4002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALL",
        "first_name": "DANIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-14",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "907921",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "40218",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olive Branch, MS

Sources for this page

Verify at the official NPI Registry.