Individual provider Active NPI

Alison W Hall, CRNP

  • Nurse Practitioner
  • Dothan, AL
National Provider Identifier
1376617050
Registry record updated Nov 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-094186 Issued in AL
Practice address
1901 Melba Dr
Dothan, AL 36301-3017
Phone
(334) 794-6611
Fax
(334) 794-6614
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1-094186 AL Primary

Addresses

Primary practice location

1901 Melba Dr
Dothan, AL 36301-3017

Mailing address

1901 Melba Dr
Dothan, AL 36301-3017
Phone (334) 794-6611

Other identifiers 1

IdentifierTypeStateIssuer
51004990OtherALBC BS OF ALABAMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20070717000737 AL Practitioner - Nurse Practitioner 4183724362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gut PCGroup PAC ID 3375589799, 53 clinicians

Practice addresses (Care Compare)

480 Honeysuckle Rd
Dothan, AL 36305-1156
Phone (334) 836-1212

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-094186ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gut PC CurrentSince Nov 17, 2012 Accepting new patients
Gut PC Current Accepting new patients

Locations

265 Medical Park Blvd
Dothan, AL 36301
Phone (334) 305-0112

480 Honeysuckle Rd
Dothan, AL 36305
Phone (334) 792-6933

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194566400000",
    "number": "1376617050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 MELBA DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013017",
            "telephone_number": "334-794-6611",
            "fax_number": "334-794-6614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 MELBA DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013017",
            "telephone_number": "334-794-6611",
            "fax_number": "334-794-6614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "ALISON",
        "middle_name": "W",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-094186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF ALABAMA",
            "identifier": "51004990",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.