Individual provider Active NPI

Nicole Ruddock Hall, MD

  • Maternal & Fetal Medicine Physician
  • Atlanta, GA
National Provider Identifier
1326129644
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
077377 Issued in GA
Practice address
1000 Johnson Ferry Rd
Atlanta, GA 30342-1606
Phone
(404) 851-8988
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X M4498 TX
Maternal & Fetal Medicine Physician 207VM0101X 077377 GA Primary

Addresses

Primary practice location

1000 Johnson Ferry Rd
Atlanta, GA 30342-1606

Mailing address

1000 Johnson Ferry Rd
Atlanta, GA 30342-1606
Phone (404) 851-8988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070207000607 TX Practitioner - Obstetrics/Gynecology 0840292652 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M4498TXMDObstetrics & Gynecology Physician
077377GAMDMaternal & Fetal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children'S Physician Group CurrentSince Oct 31, 2011 Accepting new patients
Baylor College of Medicine CurrentSince Oct 31, 2011 Accepting new patients
Baylor College of Medicine CurrentSince Oct 31, 2011 Accepting new patients
Northside Primary Care Professional Services,LLC Past Accepting new patients
Ut Physicians Past Accepting new patients
Atlanta Perinatal Consultants, LP Past Accepting new patients
Ut Physicians Obstetrics & Gynecology Past Accepting new patients

Locations

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

2 Greenway Plz
Ste 300
Houston, TX 77046
Phone (832) 828-3603

Organizations & group practices 7

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1326129644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 JOHNSON FERRY RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421606",
            "telephone_number": "404-851-8988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 JOHNSON FERRY RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421606",
            "telephone_number": "404-851-8988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "NICOLE",
        "middle_name": "RUDDOCK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "M4498",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "GA",
            "license": "077377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.