Active NPI
Jerome M Hale Jr., COMS
- Orientation and Mobility Training Rehabilitation Counselor
- San Tan Valley, AZ
National Provider Identifier
1316644818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orientation and Mobility Training Rehabilitation Counselor
- License
- 22919
- Practice address
- 335 E Mule Train TRL
San Tan Valley, AZ 85143-5612 - Phone
- (708) 724-7999
- NPI assigned
- Feb 14, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Orientation and Mobility Training Rehabilitation Counselor | 225CX0006X | 22919 | AZ | Primary |
Addresses
Primary practice location
335 E Mule Train TRL
San Tan Valley, AZ 85143-5612
Mailing address
335 E Mule Train TRL
San Tan Valley, AZ 85143-5612
Phone (708) 724-7999
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22919 | AZ | MD | Orientation and Mobility Training Rehabilitation Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676332800000",
"number": "1316644818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "335 E MULE TRAIN TRL",
"city": "SAN TAN VALLEY",
"state": "AZ",
"postal_code": "851435612",
"telephone_number": "708-724-7999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "335 E MULE TRAIN TRL",
"city": "SAN TAN VALLEY",
"state": "AZ",
"postal_code": "851435612",
"telephone_number": "708-724-7999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALE",
"first_name": "JEROME",
"middle_name": "M",
"name_suffix": "Jr.",
"credential": "COMS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-02-14",
"last_updated": "2023-02-14",
"certification_date": "2023-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "225CX0006X",
"taxonomy_group": "",
"desc": "Rehabilitation Counselor, Orientation and Mobility Training Provider",
"state": "AZ",
"license": "22919",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Tan Valley, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.