Jordan Neil Hale, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

53080 Issued in CA

Practice address

1547 Midway Dr Ste B
Ammon, ID 83406-6912

Phone

(208) 497-0429

Fax

(208) 497-0430

NPI assigned

Dec 4, 2015

Last updated

May 27, 2020By the provider in NPPES

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 ID

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

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Root Cause Integrative Medicine LLCGroup PAC ID 2062753098, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065
• Eastern Idaho Regional Medical Center Hospital, Idaho Falls, ID, CCN 130018

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jordan.hale@direct.meditouchehr.com

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.

• Root Cause Integrative Medicine LLC

  • Family Medicine Physician
  • Ammon, ID
  • NPI 1447718853
  Medicare reassignment Care Compare group Authorized official
• Premier Sports & Spine

  • Chiropractor
  • Ammon, ID
  • NPI 1023793361
  NPD

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

• Eastern Idaho Health Services Inc

  dba Eastern Idaho Regional Medical Center

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1225082209
  Care Compare affiliation
• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Care Compare affiliation

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

{
    "created_epoch": "1449187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1396110169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1547 MIDWAY DR STE B",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834066912",
            "telephone_number": "208-497-0429",
            "fax_number": "208-497-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1547 MIDWAY DR STE B",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834066912",
            "telephone_number": "208-497-0429",
            "fax_number": "208-497-0430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 W Main St",
            "address_purpose": "LOCATION",
            "city": "Turlock",
            "state": "CA",
            "postal_code": "953805107",
            "country_code": "US",
            "telephone_number": "209-668-5388",
            "fax_number": "209-668-5378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALE",
        "first_name": "JORDAN",
        "middle_name": "NEIL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-04",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "53080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Griggs
• Guardian Pharmacy of Idaho Falls, LLC (Heartland Pharmacy - Idaho Falls)
• Ashley Ann Guthrie, MS SLP CCC
• H.a.S. LLC
• H.a.S. LLC
• Avery C Hall, PA-C
• Brian Kendall Hall, DPT
• Marianne Hammer
• Brett L Hampton, LCSW
• Allison Marie Hancock, B.A

• Physician Assistant in Ammon, ID
• Providers in Ammon, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.