Avery C Hall, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5871654 Issued in ID

Practice address

3067 Eagle Dr
Ammon, ID 83406-1273

Phone

(208) 522-4600

Fax

(208) 552-7521

NPI assigned

May 6, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IGFGAA

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.

• Cristina Leon, DO PA

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  • NPI 1598383929
  NPD
• Just 4 Kids Pediatrics

  • Pediatrics Physician
  • Ammon, ID
  • NPI 1366560971
  NPD

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

{
    "created_epoch": "1746489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1629867528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3067 EAGLE DR",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834061273",
            "telephone_number": "208-522-4600",
            "fax_number": "208-552-7521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3067 EAGLE DR",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834061273",
            "telephone_number": "208-522-4600",
            "fax_number": "208-552-7521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "AVERY",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-06",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "5871654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guardian Pharmacy of Idaho Falls, LLC
• Ashley Ann Guthrie, MS SLP CCC
• H.a.S. LLC
• H.a.S. LLC
• Jordan Neil Hale, PA-C
• Brian Kendall Hall, DPT
• Marianne Hammer
• Allison Marie Hancock, B.A
• Susannah Hancock, NP
• Gabrielle Monson Hannon, LAMFT

• Physician Assistant in Ammon, ID
• Providers in Ammon, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2025; 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.