Individual provider Active NPI

Daniel Crawford Hall, M.D.

  • Family Medicine Physician
  • Shallotte, NC
National Provider Identifier
1669460374
Registry record updated Oct 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20910 Issued in NC
Practice address
5145 Sellers Rd
Shallotte, NC 28470
Phone
(910) 754-4441
NPI assigned
Oct 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20910 NC Primary

Addresses

Primary practice location

5145 Sellers Rd
Shallotte, NC 28470

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (844) 266-8268

Other practice location 1

104 Physicians Park Dr
Rockingham, NC 28379
Phone (910) 895-1989

Other practice location 2

104 Physicians Park Dr
Rockingham, NC 28379
Phone (910) 895-1989

Other practice location 3

104 Physicians Park Dr
Rockingham, NC 28379
Phone (910) 895-1989

Other practice location 4

104 Physicians Park Dr
Rockingham, NC 28379
Phone (910) 895-1989

Other identifiers 8

IdentifierTypeStateIssuer
24827OtherMEDCOST
N20910MedicaidSC
FH1000140OtherFIRST CAROLINA CARE
8938226MedicaidNC
7990526OtherAETNA
1808198001OtherCIGNA PAL
38226OtherNCBCBS
20910OtherNCSTATE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dhall528730@direct.novanthealth.org

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100105000617 NC Practitioner - Family Practice 2163563727 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, shared by 14 NPIs, 2,413 clinicians

Practice addresses (Care Compare)

512 Village Rd
Suite 103
Shallotte, NC 28470-3409
Phone (910) 754-4441

5145 Sellers Rd
Shallotte, NC 28470-3405
Phone (910) 754-4441

Hospital & facility affiliations

  • Well Care Home Health Home health agency, Wilmington, NC, CCN 347002
  • Nhrmc Home Care Home health agency, Rocky Point, NC, CCN 347065
  • Novant Health Brunswick Medical Center Hospital, Supply, NC, CCN 340158
  • Novant Health New Hanover Regional Medical Center Hospital, Wilmington, NC, CCN 340141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20910NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
FHPG, LLC Family Medicine Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jan 1, 2018 Accepting new patients
Novant Health Medical Group, LLC Family Medicine CurrentSince Jan 1, 2018 Accepting new patients
Novant Health Medical Group, LLC Family Medicine CurrentSince Mar 13, 2022 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
FHPG, LLC Family Medicine CurrentSince Oct 1, 2014 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

104 Physicians Park Dr
Rockingham, NC 28379
Phone (910) 895-1989

512 Village Rd
Ste 103
Shallotte, NC 28470
Phone (910) 754-4441

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Organizations & group practices 9

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1669460374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "844-266-8268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5145 SELLERS RD",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "28470",
            "telephone_number": "910-754-4441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 Physicians Park Dr",
            "address_purpose": "LOCATION",
            "city": "Rockingham",
            "state": "NC",
            "postal_code": "28379",
            "country_code": "US",
            "telephone_number": "910-895-1989",
            "fax_number": "910-895-9666",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 Physicians Park Dr",
            "address_purpose": "LOCATION",
            "city": "Rockingham",
            "state": "NC",
            "postal_code": "28379",
            "country_code": "US",
            "telephone_number": "910-895-1989",
            "fax_number": "910-895-9666",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 Physicians Park Dr",
            "address_purpose": "LOCATION",
            "city": "Rockingham",
            "state": "NC",
            "postal_code": "28379",
            "country_code": "US",
            "telephone_number": "910-895-1989",
            "fax_number": "910-895-9666",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 Physicians Park Dr",
            "address_purpose": "LOCATION",
            "city": "Rockingham",
            "state": "NC",
            "postal_code": "28379",
            "country_code": "US",
            "telephone_number": "910-895-1989",
            "fax_number": "910-895-9666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALL",
        "first_name": "DANIEL",
        "middle_name": "CRAWFORD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2020-10-25",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "20910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "24827",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N20910",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST CAROLINA CARE",
            "identifier": "FH1000140",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8938226",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7990526",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PAL",
            "identifier": "1808198001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "38226",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "20910",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dhall528730@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "104 Physicians Park Dr",
            "city": "Rockingham",
            "state": "NC",
            "country_code": "US",
            "postal_code": "28379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shallotte, NC

Sources for this page

Verify at the official NPI Registry.