Virginia A Hallock, N.P.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

R039856 Issued in GA

Practice address

1115 Lexington Ave
Savannah, GA 31404-5502

Phone

(912) 354-4813

Fax

(912) 354-7569

NPI assigned

Jun 2, 2005

Last updated

Aug 7, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Nephrology and Hypertension Medical Associates PC

  • Nephrology Physician
  • Beaufort, SC
  • NPI 1205261328
  NPD (past)

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

{
    "created_epoch": "1117670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407369600000",
    "number": "1649272691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15238",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314161938",
            "telephone_number": "912-354-4813",
            "fax_number": "912-354-7569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 LEXINGTON AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314045502",
            "telephone_number": "912-354-4813",
            "fax_number": "912-354-7569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLOCK",
        "first_name": "VIRGINIA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-02",
        "last_updated": "2014-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "R039856",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "SC",
            "license": "R00079381",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00929255A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0564",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Johanna Hall, M.D.
• Malaysha Deasha Hall
• Michael Anthony Hall, MD
• R Alan Hall, MD
• Zachary Hall
• Brooke Bradley Halpern, M.D.
• Sean James Halpin, PARAMEDIC
• Oscar Emerson Ham Jr., MD
• Yusuf Hasan Hameed, MD
• Latrelle Hamilton Brown

• Adult Health Nurse Practitioner in Savannah, GA
• Providers in Savannah, GA by specialty
• Adult Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2014; 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.