Jesse Ray Hall, MS, RDN, CD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

10179690 Issued in OR

Practice address

5940 Ulali Dr NE
Keizer, OR 97303-1500

Phone

(503) 304-5738

Fax

(503) 304-5725

NPI assigned

Oct 20, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA, OR2 enrollments

Enrollment records 2

Specialty

Registered Dietitian Or Nutrition Professional

Education

Washington University School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaiser Foundation Health Plan of the NorthwestGroup PAC ID 5799688230, 1,805 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1184786527

  Dietitian, Registered, WA

  Medicare reassignment Care Compare group NPD
• Erhardt Physical Therapy and Sports Medicine, LLC

  • Physical Therapist
  • Scappoose, OR
  • NPI 1326110313
  Medicare reassignment NPD
• Apple Physical Therapy, LLC

  • Physical Therapist
  • Auburn, WA
  • NPI 1902808470
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Northwest

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1942718622
  NPD
• Apple Physical Therapy LLC

  • Durable Medical Equipment & Medical Supplies
  • Mountlake Terrace, WA
  • NPI 1366746232
  NPD
• Apple Physical Therapy LLC

  • Physical Therapist
  • Yelm, WA
  • NPI 1922283050
  NPD

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

{
    "created_epoch": "1413763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1588068522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5940 ULALI DR NE",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973031500",
            "telephone_number": "503-304-5738",
            "fax_number": "630-759-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5940 ULALI DR NE",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973031500",
            "telephone_number": "503-304-5738",
            "fax_number": "503-304-5725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "JESSE",
        "middle_name": "RAY",
        "credential": "MS, RDN, CD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-20",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI60506429",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "10179690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "735 SW 158th Ave",
            "address_2": "#160",
            "city": "Beaverton",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970064952",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Grow Defined Therapy LLC
• River Miah Grow
• Kori Guntly, LMT
• Daniel Hagins
• Carolyn I Hale, MD
• Ashlyn Hamilton
• Joseph Michael Hammar, DENTURIST
• Hands of Hope Counseling LLC
• Jayson Levi Harding
• Amanda Harp

• Registered Dietitian in Keizer, OR
• Providers in Keizer, OR by specialty
• Registered Dietitian in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.