Organization Active NPI

W. Brent Hall, O.D. P.a.

  • Optometrist
  • Pine Bluff, AR
National Provider Identifier
1295760767
Registry record updated Sep 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
W. BRENT HALL, O.D. P.A.
Practice address
3001 W 28TH Ave
Pine Bluff, AR 71603-4802
Phone
(870) 541-2020
Fax
(870) 536-0358
NPI assigned
Jul 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2008

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

Authorized official

Name
Dr. William Brent Hall, O.D.NPI 1457390080
Title
Owner
Phone
(870) 541-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

3001 W 28TH Ave
Pine Bluff, AR 71603-4802

Mailing address

3001 W 28TH Ave
Pine Bluff, AR 71603-4802
Phone (870) 541-2020

Other identifiers 1

IdentifierTypeStateIssuer
158851722MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040124000176 AR Part B Supplier - Clinic/Group Practice 9436051943 Receives reassigned benefits from 3 practitioners
Practice locations: Pine Bluff, AR
O20100930001355 AR DME Supplier - Physician - Optometrist 9436051943 Practice locations: Pine Bluff, AR

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Hall Eye Care3001 W 28TH Ave, Pine Bluff, AR 71603-4802(870) 541-2020 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jul 1, 2004

National Provider Directory

National Provider Directory

Locations

3001 W 28th Ave
Pine Bluff, AR 71603
Phone (870) 535-8289

2501 W 28th Ave
Pine Bluff, AR 71603
Phone (870) 535-8289

Interoperability endpoints

  • Direct secure messaging: eyedoc14@halleyecare.eyefinity-direct.com
  • Direct secure messaging: tcovington@halleyecare.eyefinity-direct.com

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221004800000",
    "number": "1295760767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 W 28TH AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716034802",
            "telephone_number": "870-541-2020",
            "fax_number": "870-536-0358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 W 28TH AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716034802",
            "telephone_number": "870-541-2020",
            "fax_number": "870-536-0358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W. BRENT HALL, O.D. P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2008-09-10",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "BRENT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-541-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158851722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Bluff, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2008; 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.