Individual provider Active NPI

Diedre Michelle Hall

  • Physical Therapist
  • Corpus Christi, TX
National Provider Identifier
1457306433
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1112217 Issued in TX
Practice address
3229 S Alameda St
Corpus Christi, TX 78404-2507
Phone
(361) 814-4800
Fax
(361) 814-4830
NPI assigned
May 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1112217 TX Primary

Addresses

Primary practice location

3229 S Alameda St
Corpus Christi, TX 78404-2507

Mailing address

3229 S Alameda St
Corpus Christi, TX 78404-2507
Phone (361) 814-4800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051116000718 TX Practitioner - Physical Therapist in Private Practice 3870512023 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1112217TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wheelchair Clinic Inc Physical Therapist CurrentSince Feb 1, 2024 Accepting new patients
New Stride Physical Therapy & Rehabilitation Physical Therapist Past Accepting new patients
Premier Physical Therapy, Inc. Physical Therapist Past Accepting new patients
RGV-Nueces Rehabilitation, Inc. Physical Therapist Past Accepting new patients

Locations

4557 S Western St
Ste B4
Amarillo, TX 79109
Phone (801) 440-5592

2021 E Village Green Cir
Ste C
Draper, UT 84020
Phone (801) 440-5592

Organizations & group practices 4

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1457306433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3229 S ALAMEDA ST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784042507",
            "telephone_number": "361-814-4800",
            "fax_number": "361-184-4830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3229 S ALAMEDA ST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784042507",
            "telephone_number": "361-814-4800",
            "fax_number": "361-814-4830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "DIEDRE",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1112217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.