Individual provider Active NPI

Dustin James Hall, D.O.

  • Obstetrics & Gynecology Physician
  • Marshall, MI
National Provider Identifier
1437353935
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
5101017202 Issued in MI
Practice address
215 E Mansion St Ste 3D
Marshall, MI 49068-1167
Phone
(269) 558-0702
NPI assigned
Jun 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X OP60222872 WA
Obstetrics & Gynecology Physician 207V00000X 5101017202 MI Primary

Addresses

Primary practice location

215 E Mansion St Ste 3D
Marshall, MI 49068-1167

Mailing address

215 E Mansion St Ste 3D
Marshall, MI 49068-1167
Phone (269) 558-0702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130727000080 MI Practitioner - Obstetrics/Gynecology 4284805722 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Michigan State University College of Osteopathic Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ella E M Brown Charitable CircleGroup PAC ID 1254228745, 172 clinicians

Practice addresses (Care Compare)

215 E Mansion St
1E Oaklawn Medical Group
Marshall, MI 49068-1559
Phone (269) 789-8272

Hospital & facility affiliations

  • Oaklawn Hospital Hospital, Marshall, MI, CCN 230217

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Ella E M Brown Charitable Circle CurrentSince Jun 17, 2024 Accepting new patients
Ella E M Brown Charitable Circle Current Accepting new patients
Intercare Community Health Network CurrentSince Jun 2, 2014 Accepting new patients
Ella E M Brown Charitable Circle CurrentSince Jun 17, 2024 Accepting new patients
Intercare Community Health Network CurrentSince Jun 2, 2014 Accepting new patients
Ella E M Brown Charitable Circle Past Accepting new patients
Ella E. M. Brown Charitable Circle Past Accepting new patients

Locations

50 Industrial Park Rd
Bangor, MI 49013
Phone (269) 427-7937

800 M 139
Benton Harbor, MI 49022
Phone (269) 927-5400

200 N Madison St
Marshall, MI 49068
Phone (269) 789-3921

215 E Mansion St
Ste 3D
Marshall, MI 49068
Phone (269) 558-0702

215 E Mansion St
Ste 1E
Marshall, MI 49068
Phone (269) 781-3938

Interoperability endpoints

  • Direct secure messaging: dustin.hall.1@9698.direct.athenahealth.com

Organizations & group practices 8

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": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1437353935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E MANSION ST STE 3D",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "490681167",
            "telephone_number": "269-558-0702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E MANSION ST STE 3D",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "490681167",
            "telephone_number": "269-558-0702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "DUSTIN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-11",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "OP60222872",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5101017202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshall, MI

Sources for this page

Verify at the official NPI Registry.