Jacqueline Hall

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

201500067NP-PP Issued in WA

Practice address

1345 Birch Ave
Cottage Grove, OR 97424-1416

Phone

(541) 942-3939

NPI assigned

Dec 27, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR, WA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jhall684099@direct.ochin.org
• Direct secure messaging: jacqueline.hall.p1@direct.lanecounty.nextgenshare.com

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.

• HIV Alliance

  dba Alliance for Community Wellness

  • Case Management Agency
  • Eugene, OR
  • NPI 1295134708
  Medicare reassignment NPD
• Lane County Oregon

  dba Community health Centers of Lane County

  • Federally Qualified Health Center (FQHC)
  • Springfield, OR
  • NPI 1326138314
  Medicare reassignment NPD
• Lifeworks NW

  • Mental Health Counselor
  • Portland, OR
  • NPI 1467408013
  Medicare reassignment NPD
• Telecare Mental Health Services of Washington, Inc

  dba Telecare Recovery Partnership

  • Psychiatric Residential Treatment Facility
  • Tacoma, WA
  • NPI 1780913657
  Medicare reassignment NPD
• Telecare Mental Health Services of Washington Inc

  dba King County PACT

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tukwila, WA
  • NPI 1902540362
  NPD
• Telecare Mental Health Services of Washington, Inc

  dba Telecare Shelton Next Steps

  • Mental Illness Community Based Residential Treatment Facility
  • Shelton, WA
  • NPI 1134737737
  NPD
• Lutheran Community Services NW

  • Mental Health Counselor
  • Bend, OR
  • NPI 1093074882
  NPD (past)
• Telecare Mental Health Services of Washington, Inc

  dba Telecare King County E&T

  • Mental Illness Community Based Residential Treatment Facility
  • Federal Way, WA
  • NPI 1790298347
  NPD (past)

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

{
    "created_epoch": "1419638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1508254517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "492 E 13TH AVE STE 205",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014250",
            "telephone_number": "541-513-2625",
            "fax_number": "541-505-9042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 BIRCH AVE",
            "city": "COTTAGE GROVE",
            "state": "OR",
            "postal_code": "974241416",
            "telephone_number": "541-942-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-27",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201500067NP-PP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "201500067NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grove Care Clinic LLC
• Susan Grzesiak
• Asha Latha Guntupalli
• Gurule Chiropractic (Thomas Chiropractic)
• Raymond B Hadley, D.D.S.
• Amanda Marceda Hampton
• Michael W. Hankins, RPH
• June Harriger
• James F Harrison, M.D.
• Tessa Hart, MED, QMHP

• Psychiatric/Mental Health Nurse Practitioner in Cottage Grove, OR
• Providers in Cottage Grove, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.