Individual provider Active NPI

Andrea Lewis Hall, NP

  • Acute Care Nurse Practitioner
  • Balch Springs, TX
National Provider Identifier
1376143529
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1027664 Issued in TX
Practice address
14721 Arborcrest Dr
Balch Springs, TX 75180-3642
Phone
(972) 310-1440
NPI assigned
Oct 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 611521 TX
Acute Care Nurse Practitioner 363LA2100X 1027664 TX Primary

Addresses

Primary practice location

14721 Arborcrest Dr
Balch Springs, TX 75180-3642

Mailing address

14721 Arborcrest Dr
Balch Springs, TX 75180-3642
Phone (972) 310-1440

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220218001681 TX Practitioner - Nurse Practitioner 1456745306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Physician Resources, LLPGroup PAC ID 7012161375, 91 clinicians

Practice addresses (Care Compare)

2700 E Broad St
Mansfield, TX 76063-5899
Phone (682) 622-2000

Hospital & facility affiliations

  • Methodist Charlton Medical Center Hospital, Dallas, TX, CCN 450723

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
611521TXMDEmergency Registered Nurse
1027664TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Physician Resources, LLP CurrentSince Jan 1, 2022 Accepting new patients

Locations

1441 N Beckley Ave
Dallas, TX 75203
Phone (214) 712-2429

2700 E Broad St
Mansfield, TX 76063
Phone (682) 242-2000

1201 E Highway 287
Midlothian, TX 76065
Phone (469) 695-2065

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1376143529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14721 ARBORCREST DR",
            "city": "BALCH SPRINGS",
            "state": "TX",
            "postal_code": "751803642",
            "telephone_number": "972-310-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14721 ARBORCREST DR",
            "city": "BALCH SPRINGS",
            "state": "TX",
            "postal_code": "751803642",
            "telephone_number": "972-310-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "ANDREA",
        "middle_name": "LEWIS",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-27",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "TX",
            "license": "611521",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1027664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Balch Springs, TX

Sources for this page

Verify at the official NPI Registry.