Individual provider Active NPI

Ruth A Hall, RN, CPNP-AC, MHA

  • Pediatric Nurse Practitioner
  • Lake Charles, LA
National Provider Identifier
1356415723
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN112569 AP04749 Issued in LA
Practice address
2300 Medora St
Lake Charles, LA 70601-1204
Phone
(337) 437-3977
NPI assigned
Nov 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN112569 AP04749 LA Primary
Pediatric Nurse Practitioner 363LP0200X 453410 TX

Addresses

Primary practice location

2300 Medora St
Lake Charles, LA 70601-1204

Mailing address

5864 Hidden Meadows Dr
Orange, TX 77632-3635
Phone (409) 746-9201

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN112569 AP04749LAMDPediatric Nurse Practitioner
453410TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Health Southwestern Louisiana PastSince Jul 10, 2022 Accepting new patients
Christus Health Southwestern Louisiana Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356415723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5864 HIDDEN MEADOWS DR",
            "city": "ORANGE",
            "state": "TX",
            "postal_code": "776323635",
            "telephone_number": "409-746-9201",
            "fax_number": "409-746-9204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 MEDORA ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706011204",
            "telephone_number": "337-437-3977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "RUTH",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "RN, CPNP-AC, MHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "LA",
            "license": "RN112569 AP04749",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "453410",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.