Individual provider Active NPI

Jack J Hall, MD

  • Interventional Cardiology Physician
  • Springfield, IL
National Provider Identifier
1558337857
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
04-41951 Issued in KS
Practice address
619 E Mason St Ste 4P57
Springfield, IL 62701
Phone
(217) 788-0706
Fax
(217) 525-2535
NPI assigned
Feb 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 01038562A IN
Interventional Cardiology Physician 207RI0011X 04-41951 KS Primary
Interventional Cardiology Physician 207RI0011X 129026 MT
Interventional Cardiology Physician 207RI0011X 13144 WI
Interventional Cardiology Physician 207RI0011X 01038562A IN
Interventional Cardiology Physician 207RI0011X 036136720 IL

Addresses

Primary practice location

619 E Mason St Ste 4P57
Springfield, IL 62701

Mailing address

619 E Mason St Ste 4P57
Springfield, IL 62701-1034
Phone (217) 788-0706

Other practice location 1

2220 Canterbury Dr
Hays, KS 67601-2370
Phone (785) 625-4699

Other practice location 2

3400 Ministry Pkwy
Weston, WI 54476-5220
Phone (715) 393-1000

Other identifiers 2

IdentifierTypeStateIssuer
200063500MedicaidIN
P01427268OtherILRAILROAD

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jhall99964@ewd.direct.hshs.org Direct
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL, DE, MT, WI5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20040623000130 IN Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 6709861743 Reassigns benefits to 2 organizations
I20141118001227 IL Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Other (Physician) 6709861743 Reassigns benefits to 3 organizations
I20230920004093 DE Practitioner - Family Practice 6709861743 Reassigns benefits to 1 organization
I20230926000485 MT Practitioner - Interventional Cardiology 6709861743 Reassigns benefits to 1 organization
I20250228001446 WI Practitioner - Interventional CardiologyPractitioner - Internal Medicine 6709861743 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Indiana University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beacon Medical Group IncGroup PAC ID 1254243306, 575 clinicians

Practice addresses (Care Compare)

610 N Michigan St
South Bend, IN 46601-1081
Phone (574) 647-8120

615 N Michigan St
South Bend, IN 46601-1033

615 N Michigan St FL
South Bend, IN 46601-1033

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01038562AINMDCardiovascular Disease Physician
129026MTMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group, Inc. Cardiovascular Disease CurrentSince Sep 10, 2024 Accepting new patients
Flambeau Hospital Inc Current Accepting new patients
Lakeview Medical Center Inc of Rice Lake Cardiovascular Disease CurrentSince Feb 21, 2025 Accepting new patients
Beacon Medical Group, Inc. Cardiovascular Disease Current Accepting new patients
Flambeau Hospital Inc CurrentSince Feb 21, 2025 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Feb 21, 2025 Accepting new patients
MCHS Hospitals Inc CurrentSince Feb 21, 2025 Accepting new patients
Good Samaritan Regional Health Center Interventional Cardiology CurrentSince Apr 9, 2025 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Feb 21, 2025 Accepting new patients
St. Mary's Hospital, Centralia, Illinois Interventional Cardiology CurrentSince Jun 1, 2024 Accepting new patients
St. Mary's Hospital, Centralia, Illinois CurrentSince Jun 1, 2024 Accepting new patients
Tidalhealth Specialty Care, LLC CurrentSince Jun 28, 2023 Accepting new patients
Beacon Medical Group Inc CurrentSince Sep 10, 2024 Accepting new patients
Physician Services Corporation of Southern Illinois Inc. CurrentSince May 31, 2024 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Benefis Hospitals Inc CurrentSince Sep 12, 2023 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Feb 21, 2025 Accepting new patients
La Porte Clinic Company LLC Cardiovascular Disease CurrentSince May 1, 2023 Accepting new patients
Memorial Hospital Inc CurrentSince Feb 21, 2025 Accepting new patients
MCHS Hospitals Inc CurrentSince Feb 21, 2025 Accepting new patients
Marshfield Clinic Inc CurrentSince Feb 21, 2025 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
La Porte Clinic Company LLC CurrentSince May 1, 2023 Accepting new patients
Indiana University Health, Inc Cardiovascular Disease Past Accepting new patients
St. Vincent Medical Group, Inc. Past Accepting new patients
Major Hospital Past Accepting new patients
The Care Labs, LLC Past Accepting new patients
St. Vincent Carmel Hospital, Inc. Past Accepting new patients
Care Group LLC Cardiovascular Disease Past Accepting new patients
St. Vincent Hospital & Health Care Center, Inc. Past Accepting new patients

Locations

200 Federal St
Seaford, DE 19973
Phone (302) 629-9099

400 N Pleasant Ave
Centralia, IL 62801
Phone (618) 436-5221

7420 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-3155

5 Good Samaritan Way
Mount Vernon, IL 62864
Phone (557) 203-1601

2 Good Samaritan Way
Ste 320
Mount Vernon, IL 62864
Phone (618) 899-1944

1 Good Samaritan Way
Mount Vernon, IL 62864
Phone (618) 242-4600

605 N 12th St
Mount Vernon, IL 62864
Phone (618) 241-1108

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129

104 E Culver Rd
Ste 105
Knox, IN 46534
Phone (574) 772-7300

1331 State St
Laporte, IN 46350
Phone (219) 326-2415

610 N Michigan St
Ste 400
South Bend, IN 46601
Phone (574) 204-7333

100 E Carroll St
Salisbury, MD 21801
Phone (410) 543-7100

1101 26th St S
Fl 5
Great Falls, MT 59405
Phone (406) 455-2132

1300 28th St S
Ste 2
Great Falls, MT 59405
Phone (406) 731-2362

1101 26th St S
Great Falls, MT 59405
Phone (406) 455-4690

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

3400 Ministry Pkwy
Weston, WI 54476
Phone (715) 393-1000

Interoperability endpoints

  • Direct secure messaging: jhall511711@direct-ehr-ssmhc.com
  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com
  • Direct secure messaging: jhall99964@ewd.direct.hshs.org

Organizations & group practices 30

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.

View all 30

Hospital & facility affiliations 3

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": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1558337857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 E MASON ST STE 4P57",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627011034",
            "telephone_number": "217-788-0706",
            "fax_number": "217-525-2535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 E MASON ST STE 4P57",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "62701",
            "telephone_number": "217-788-0706",
            "fax_number": "217-525-2535"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2220 Canterbury Dr",
            "address_purpose": "LOCATION",
            "city": "Hays",
            "state": "KS",
            "postal_code": "676012370",
            "country_code": "US",
            "telephone_number": "785-625-4699",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3400 Ministry Pkwy",
            "address_purpose": "LOCATION",
            "city": "Weston",
            "state": "WI",
            "postal_code": "544765220",
            "country_code": "US",
            "telephone_number": "715-393-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALL",
        "first_name": "JACK",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "01038562A",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "KS",
            "license": "04-41951",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MT",
            "license": "129026",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "WI",
            "license": "13144",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IN",
            "license": "01038562A",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "036136720",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200063500",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P01427268",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhall99964@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "619 E Mason St Ste 4P57",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "62701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "3400 Ministry Pkwy",
            "city": "Weston",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544765220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.