John Boren Hallett, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A178101 Issued in CA

Practice address

5900 State Farm Dr Ste 200
Rohnert Park, CA 94928-2149

Phone

(707) 559-7500

Fax

(707) 559-7707

NPI assigned

Mar 17, 2019

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

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: jhallett614279@direct.ochin.org

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.

• Petaluma Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Rohnert Park, CA
  • NPI 1669870739
  NPD (past)
• SRM Alliance Hospital Services

  • Skilled Nursing Facility
  • Petaluma, CA
  • NPI 1770703886
  NPD (past)

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

{
    "created_epoch": "1552780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1619436995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1179 N MCDOWELL BLVD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949546559",
            "telephone_number": "707-559-7500",
            "fax_number": "707-559-7707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 STATE FARM DR STE 200",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949282149",
            "telephone_number": "707-559-7500",
            "fax_number": "707-559-7707"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4860 Y St Ste 2500",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958172307",
            "country_code": "US",
            "telephone_number": "916-734-6978",
            "fax_number": "916-734-6666",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1179 N McDowell Blvd",
            "address_purpose": "LOCATION",
            "city": "Petaluma",
            "state": "CA",
            "postal_code": "949546559",
            "country_code": "US",
            "telephone_number": "707-559-7500",
            "fax_number": "707-559-7707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALLETT",
        "first_name": "JOHN",
        "middle_name": "BOREN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-17",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A178101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karl Greer, MD
• Isabella Gregoretti
• James Thomas Grier Jr.
• Sidney Ha
• Elizabeth Hadsell, CMT
• Christie Lynne Hamilton
• Shayna Hammer
• Linda Renne Hankins, R.N.
• Rex Dell Harner, M.D.
• Sally Anne Harper, D.C.

• Family Medicine Physician in Rohnert Park, CA
• Providers in Rohnert Park, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.