Individual provider Active NPI

Michelle Lynnette Hall, M.D.

  • Family Medicine Physician
  • Lake Buena Vista, FL
National Provider Identifier
1558741686
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME136536 Issued in FL
Practice address
960 Back Stage LN
Lake Buena Vista, FL 32830-8472
Phone
(407) 934-4100
Fax
(407) 934-4101
NPI assigned
Jun 3, 2015
Last updated
Mar 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME136536 FL Primary
Family Medicine Physician 207Q00000X 000000000000 MO

Addresses

Primary practice location

960 Back Stage LN
Lake Buena Vista, FL 32830-8472

Mailing address

960 Back Stage LN
Lake Buena Vista, FL 32830-8472
Phone (407) 934-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20181212000165 FL Practitioner - Family Practice 8729381280 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME136536FLMDFamily Medicine Physician
000000000000MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Family Medicine CurrentSince Sep 1, 2019 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Sep 1, 2019 Accepting new patients
Bond Urgent Care LLC Past Accepting new patients

Locations

410 Lionel Way
Fl 3
Davenport, FL 33837
Phone (863) 419-2420

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

Interoperability endpoints

  • Direct secure messaging: michelle.hall.p1@direct.bondclinicpa.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1558741686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 BACK STAGE LN",
            "city": "LAKE BUENA VISTA",
            "state": "FL",
            "postal_code": "328308472",
            "telephone_number": "407-934-4100",
            "fax_number": "407-934-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 BACK STAGE LN",
            "city": "LAKE BUENA VISTA",
            "state": "FL",
            "postal_code": "328308472",
            "telephone_number": "407-934-4100",
            "fax_number": "407-934-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "MICHELLE",
        "middle_name": "LYNNETTE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-03",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME136536",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "000000000000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Buena Vista, FL

Sources for this page

Verify at the official NPI Registry.