Active NPI
Robert B Hall, PHD
- Psychologist
- Canandaigua, NY
National Provider Identifier
1366554610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 008194
- Practice address
- 3019 County Complex Dr
Canandaigua, NY 14424-9505 - Phone
- (585) 396-4363
- Fax
- (585) 396-4993
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 008194 | NY | Primary |
Addresses
Primary practice location
3019 County Complex Dr
Canandaigua, NY 14424-9505
Mailing address
122 Chadbourne Rd
Rochester, NY 14618-1137
Phone (585) 271-6972
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06800008194 | Medicaid | NY | |
| EM | Other | NY | EXCELLUS |
| 014003729 | Other | NY | EXCELLUS |
| 103283EU | Other | NY | PREFERRED CARE |
| 3109089 | Other | NY | VALUE OPTIONS |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008194 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316390400000",
"number": "1366554610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "122 CHADBOURNE RD",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146181137",
"telephone_number": "585-271-6972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3019 COUNTY COMPLEX DR",
"city": "CANANDAIGUA",
"state": "NY",
"postal_code": "144249505",
"telephone_number": "585-396-4363",
"fax_number": "585-396-4993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "ROBERT",
"middle_name": "B",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2011-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "008194",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "06800008194",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EXCELLUS",
"identifier": "EM",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EXCELLUS",
"identifier": "014003729",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CARE",
"identifier": "103283EU",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "3109089",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Canandaigua, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.