Individual provider Active NPI

James B. Halla, PSY.D.

  • Psychologist
  • Manchester, NH
National Provider Identifier
1417050972
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
698 Issued in NH
Practice address
250 Commercial Street
Suite 3004
Manchester, NH 03101-1118
Phone
(603) 668-3050
Fax
(603) 668-8666
NPI assigned
Sep 7, 2006
Last updated
Sep 18, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 698 NH Primary

Addresses

Primary practice location

250 Commercial Street
Suite 3004
Manchester, NH 03101-1118

Mailing address

250 Commercial Street
Suite 3004
Manchester, NH 03101-1118
Phone (603) 668-3050

Other identifiers 2

IdentifierTypeStateIssuer
30421575MedicaidNH
30423011MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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

Enrollment IDStateProvider typePAC IDDetails
I20060323000427 NH Practitioner - Clinical Psychologist 9638187255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Green House Group PAGroup PAC ID 1153370549, 5 clinicians

Practice addresses (Care Compare)

250 Commercial St
Suite 3004
Manchester, NH 03101-1118
Phone (603) 668-3050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
698NHMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Green House Group PA Psychologist CurrentSince Oct 15, 2010 Accepting new patients

Locations

250 Commercial St
Ste 3004
Manchester, NH 03101
Phone (603) 505-6249

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1417050972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 COMMERCIAL STREET",
            "address_2": "SUITE 3004",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011118",
            "telephone_number": "603-668-3050",
            "fax_number": "603-668-8666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 COMMERCIAL STREET",
            "address_2": "SUITE 3004",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011118",
            "telephone_number": "603-668-3050",
            "fax_number": "603-668-8666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLA",
        "first_name": "JAMES",
        "middle_name": "B.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NH",
            "license": "698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30421575",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30423011",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.