Active NPI
Shawn Hall, M.D.
- Family Medicine Physician
- Gonzales, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 10010R
- Practice address
- 2647 S Saint Elizabeth Blvd Ste 100
Gonzales, LA 70737-5019 - Phone
- (225) 765-5500
- Fax
- (225) 644-5415
- NPI assigned
- Jul 13, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 10010R | LA | Primary |
Addresses
Primary practice location
2647 S Saint Elizabeth Blvd Ste 100
Gonzales, LA 70737-5019
Mailing address
2647 S Saint Elizabeth Blvd Ste 100
Gonzales, LA 70737-5019
Phone (225) 765-5500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1970816 | Medicaid | LA |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | shall3401@direct.casso.us.com | Direct | |
| FHIR URL | https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Texas Southwestern Medical School at Dallas, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2647 S Saint Elizabeth Blvd
Suite 100
Gonzales, LA 70737-5019
Phone (225) 647-8511
Hospital & facility affiliations
- Feliciana Home Health South
- Our Lady of the Lake Regional Medical Center
- Womans Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10010R | LA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Our Lady of the Lake Physician Group LLC | Family Medicine | Current | Accepting new patients |
| Our Lady of the Lake Physician Group LLC | Current | Accepting new patients | |
| Our Lady of the Lake Physician Group, LLC | Current | Accepting new patients | |
| Our Lady of the Lake Physician Group LLC | Past | Accepting new patients | |
| Ascension Surgical Associates, LLC | Past | Accepting new patients |
Locations
5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011
2647 S Saint Elizabeth Blvd
Ste 100
Gonzales, LA 70737
Phone (225) 743-2707
2647 S Saint Elizabeth Blvd
Ste 125
Gonzales, LA 70737
Phone (225) 647-9675
1702 N Burnside Ave
#B
Gonzales, LA 70737
Phone (225) 647-8319
Organizations & group practices 5
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.
-
- Internal Medicine Physician
- Baton Rouge, LA
- NPI 1033494943
Family Medicine
-
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Baton Rouge, LA
- NPI 1235912502
-
- Urgent Care Clinic/Center
- Baton Rouge, LA
- NPI 1588062079
-
- Surgery Physician
- Gonzales, LA
- NPI 1184693582
-
- Hematology & Oncology Physician
- Baton Rouge, LA
- NPI 1184671455
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Gonzales, LA
- NPI 1770530651
-
- General Acute Care Hospital
- Baton Rouge, LA
- NPI 1366436123
-
- General Acute Care Hospital
- Baton Rouge, LA
- NPI 1912943184
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616457600000",
"number": "1306844147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2647 S SAINT ELIZABETH BLVD STE 100",
"city": "GONZALES",
"state": "LA",
"postal_code": "707375019",
"telephone_number": "225-765-5500",
"fax_number": "225-644-5415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2647 S SAINT ELIZABETH BLVD STE 100",
"city": "GONZALES",
"state": "LA",
"postal_code": "707375019",
"telephone_number": "225-765-5500",
"fax_number": "225-644-5415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "SHAWN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-13",
"last_updated": "2021-03-23",
"certification_date": "2021-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "LA",
"license": "10010R",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1970816",
"state": "LA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "shall3401@direct.casso.us.com",
"affiliation": "N",
"endpointDescription": "FMOLHS-Epic",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "shall3401@direct.casso.us.com",
"address_1": "2647 S Saint Elizabeth Blvd Ste 100",
"city": "Gonzales",
"state": "LA",
"country_code": "US",
"postal_code": "707375019",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "FMOLHS FHIR URL",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "FHIR API",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "2647 S Saint Elizabeth Blvd Ste 100",
"city": "Gonzales",
"state": "LA",
"country_code": "US",
"postal_code": "707375019",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Gonzales, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.