Active NPI
Jack J Hall, MD
- Interventional Cardiology Physician
- Springfield, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Cardiology Physician
- License
- 04-41951
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200063500 | Medicaid | IN | |
| P01427268 | Other | IL | RAILROAD |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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, WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 5
Care Compare profile
Medicare Care Compare- Specialty
- Interventional Cardiology
- Education
- Indiana University School of Medicine, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
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
| Procedure | Number of procedures |
|---|---|
| Coronary angioplasty and stenting | 23 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01038562A | IN | MD | Cardiovascular Disease Physician |
| 129026 | MT | MD | Interventional Cardiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beacon Medical Group, Inc. | Cardiovascular Disease | Current | Accepting new patients |
| Flambeau Hospital Inc | Current | Accepting new patients | |
| Lakeview Medical Center Inc of Rice Lake | Cardiovascular Disease | Current | Accepting new patients |
| Beacon Medical Group, Inc. | Cardiovascular Disease | Current | Accepting new patients |
| Flambeau Hospital Inc | Current | Accepting new patients | |
| Beaver Dam Community Hospitals Inc | Current | Accepting new patients | |
| MCHS Hospitals Inc | Current | Accepting new patients | |
| Good Samaritan Regional Health Center | Interventional Cardiology | Current | Accepting new patients |
| Lakeview Medical Center Inc of Rice Lake | Current | Accepting new patients | |
| St. Mary's Hospital, Centralia, Illinois | Interventional Cardiology | Current | Accepting new patients |
| St. Mary's Hospital, Centralia, Illinois | Current | Accepting new patients | |
| Tidalhealth Specialty Care, LLC | Current | Accepting new patients | |
| Beacon Medical Group Inc | Current | Accepting new patients | |
| Physician Services Corporation of Southern Illinois Inc. | Current | Accepting new patients | |
| MCHS Hospitals Inc | Current | Accepting new patients | |
| Benefis Hospitals Inc | Current | Accepting new patients | |
| Beaver Dam Community Hospitals Inc | Current | Accepting new patients | |
| La Porte Clinic Company LLC | Cardiovascular Disease | Current | Accepting new patients |
| Memorial Hospital Inc | Current | Accepting new patients | |
| MCHS Hospitals Inc | Current | Accepting new patients | |
| Marshfield Clinic Inc | Current | Accepting new patients | |
| MCHS Hospitals Inc | Current | Accepting new patients | |
| La Porte Clinic Company LLC | Current | 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
- jhall511711@direct-ehr-ssmhc.com
- him@marshfieldclinichealthsystem.cernerdirect.com
- 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.
-
dba Beacon Medical Group Schwartz - Wiekamp
- Family Medicine Physician
- Mishawaka, IN
- NPI 1033161617
Cardiovascular Disease
-
dba SSM Health Good Samaritan Hospital - Mt. Vernon
- Emergency Medicine Physician
- Mount Vernon, IL
- NPI 1487758801
Interventional Cardiology
-
dba SSM Health Medical Group
- Internal Medicine Physician
- Mount Vernon, IL
- NPI 1831101807
-
dba SSM Health St. Mary's Hospital - Centralia
- Emergency Medicine Physician
- Centralia, IL
- NPI 1770687196
Interventional Cardiology
-
dba Marshfield Medical Center - Beaver Dam Professional Services
- Clinic/Center
- Beaver Dam, WI
- NPI 1972188555
-
dba Benefis Medical Group
- Multi-Specialty Clinic/Center
- Great Falls, MT
- NPI 1780968974
-
dba MMC - Park Falls Outreach Services
- Clinic/Center
- Park Falls, WI
- NPI 1194317966
-
dba Marshfield Medical Center - Park Falls
- Critical Access Hospital
- Park Falls, WI
- NPI 1700963048
-
- Internal Medicine Physician
- Valparaiso, IN
- NPI 1568829224
Cardiovascular Disease
-
dba Marshfield Medical Center - Rice Lake Professional Services
- Clinic/Center
- Rice Lake, WI
- NPI 1093201832
-
dba Marshfield Clinic Florida Teleradiology/Telehealth
- Clinic/Center
- Marshfield, WI
- NPI 1952347981
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- South Bend, IN
- NPI 1295772093
-
dba Memorial Epworth Center
- Psychiatric Hospital Unit
- South Bend, IN
- NPI 1376841395
-
dba Beacon Granger Hospital, A Memorial Hospital Extension
- General Acute Care Hospital
- Granger, IN
- NPI 1881177756
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.