John Hall, M.D., P.C.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

36060706 Issued in IL

Legal business name

JOHN HALL, M.D., P.C.

Practice address

3505 Broadway St
Ste a
Mount Vernon, IL 62864-2202

Phone

(618) 244-7788

Fax

(618) 244-9330

NPI assigned

Aug 31, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John T Hall, M.D.

Title

President/Owner

Phone

(618) 244-7788

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Cathy Diane Lisenby, PA-C

  • Physician Assistant
  • Mount Vernon, IL
  • NPI 1346356524
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558473645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 BROADWAY ST",
            "address_2": "STE A",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642202",
            "telephone_number": "618-244-7788",
            "fax_number": "618-244-9330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 BROADWAY ST",
            "address_2": "STE A",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642202",
            "telephone_number": "618-244-7788",
            "fax_number": "618-244-9330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN HALL, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "618-244-7788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "IL",
            "license": "36060706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judy K Jenkins, LPN
• Brittany L Jerger
• JJR Enterprises Inc
• JJR Enterprises Inc (Sutton House)
• John Hall MD Rural Health Services
• Andrew Robert Johnson, M.D.
• Diane C Johnson, LCSW
• Mallory Johnston, MHP
• Megan Arlicia Kaye Jones, L.P.N
• Serena Gail Jones

• Adult Medicine Physician in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Adult Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.