Daniel Jerome Hall, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW30964 Issued in ID

Practice address

717 Mission Road
Fort Hall, ID 83203

Phone

(208) 237-5631

Fax

(208) 237-5796

NPI assigned

Oct 30, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Shoshone Bannock Tribes, Inc

  • Clinic/Center
  • Fort Hall, ID
  • NPI 1225414519

  TX

  Medicare reassignment NPD
• Shoshone Bannock Tribes, Inc

  • Clinic/Center
  • Fort Hall, ID
  • NPI 1801949763
  NPD (past)

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

{
    "created_epoch": "1414627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414627200000",
    "number": "1366847428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306",
            "city": "FORT HALL",
            "state": "ID",
            "postal_code": "832030306",
            "telephone_number": "208-237-5631",
            "fax_number": "208-237-5796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 MISSION ROAD",
            "city": "FORT HALL",
            "state": "ID",
            "postal_code": "83203",
            "telephone_number": "208-237-5631",
            "fax_number": "208-237-5796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "DANIEL",
        "middle_name": "JEROME",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-30",
        "last_updated": "2014-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW30964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela L Clarke, PN
• Gary Dale Conder, ICADC
• Kevin Robert Denny, PHARMD
• Joanne Fletcher, RN
• Fort Hall Indian Health Services
• Valarie Ann Kaser, LPN
• Kristina M Kniffen, PN-14938
• Douglas Lyons, D.O.
• Cameron Jo Marshall, PHARMD
• Deeanne M Marshall, RN

• Clinical Social Worker in Fort Hall, ID
• Providers in Fort Hall, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2014; 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.