Individual provider Active NPI

Juawana Coleman Hall, O.D.

  • Optometrist
  • Winston Salem, NC
National Provider Identifier
1659359537
Registry record updated Jun 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2000 Issued in NC
Practice address
2341 Winterhaven LN
Winston Salem, NC 27103-6792
Phone
(336) 760-2020
Fax
(336) 310-0010
NPI assigned
Jan 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2000 NC Primary

Addresses

Primary practice location

2341 Winterhaven LN
Winston Salem, NC 27103-6792

Mailing address

2341 Winterhaven LN
Winston Salem, NC 27103-6792
Phone (336) 760-2020

Other identifiers 1

IdentifierTypeStateIssuer
5902677MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051105000278 NC Practitioner - Optometry 2365460516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hillcrest Vision OD PAGroup PAC ID 5395800411, 3 clinicians

Practice addresses (Care Compare)

2341 Winterhaven LN
Winston Salem, NC 27103-6792
Phone (336) 760-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2000NCMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Hillcrest Vision, O.D., P.a. Optometrist CurrentSince Oct 22, 2008 Accepting new patients
Triad Eye Associates of Asheboro OD PA Optometrist Past Accepting new patients
Donald J Digby MD PA PastSince Sep 10, 2012 Accepting new patients
Donald J Digby MD PA Optometrist Past Accepting new patients

Locations

2341 Winterhaven Ln
Winston Salem, NC 27103
Phone (336) 760-2020

Interoperability endpoints

  • Direct secure messaging: jch@hillcrestvision.emadirect.md

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243814400000",
    "number": "1659359537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2341 WINTERHAVEN LN",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036792",
            "telephone_number": "336-760-2020",
            "fax_number": "336-760-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2341 WINTERHAVEN LN",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036792",
            "telephone_number": "336-760-2020",
            "fax_number": "336-310-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "JUAWANA",
        "middle_name": "COLEMAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-03",
        "last_updated": "2009-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5902677",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.