Elizabeth Anne Hall, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

5101019021 Issued in MI

Practice address

21931 E 9 Mile Rd
Saint Clair Shores, MI 48080-2906

Phone

(586) 443-4950

Fax

(586) 443-4980

NPI assigned

Oct 14, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Elizabeth Anne Grondin Former name

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Henry Ford Health St. John Hospital

  • Podiatrist
  • Harrison Township, MI
  • NPI 1043478910
  Medicare reassignment NPD
• Henry Ford Health St. John Hospital

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1912965088

  Pediatrics

  NPD
• Henry Ford Health St. John Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1023088168
  NPD

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

{
    "created_epoch": "1287014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1336459221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21931 E 9 MILE RD",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802906",
            "telephone_number": "586-443-4950",
            "fax_number": "586-443-4980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21931 E 9 MILE RD",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802906",
            "telephone_number": "586-443-4950",
            "fax_number": "586-443-4980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-14",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101019021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "GRONDIN",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Savannah Hadley
• Sarah Hagle, MD
• Tina Hakala
• Christopher Michael Hakim, MD
• Joshua James Halas, DPT
• Shoshana Deann Hallowell, M.D.
• Mark A. Halonen, D.O.
• Raghad Hamami
• Danni Nicole Hamilton, NMD
• Diane Marie Hamilton, MA, LLP

• Pediatrics Physician in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.