Jason S. Hallock, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1317 Issued in TN

Practice address

2525 Desales Avenue
Chattanooga, TN 37404

Phone

(423) 697-0014

Fax

(423) 648-6280

NPI assigned

Jun 19, 2006

Last updated

Feb 12, 2021By the provider in NPPES

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

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in TN, VA, GA, FL, KY5 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 5

Specialty

Physician Assistant

Education

Other, 2005

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• King's Daughters' Medical Center Hospital, Ashland, KY, CCN 180009

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Hospital Medicine Services of TN, LLC

  • Hospitalist Physician
  • Nashville, TN
  • NPI 1982301065

  Physician Assistant

  Medicare reassignment NPD
• Kentucky Em-I Medical Services PSC

  • Emergency Medicine Physician
  • Ashland, KY
  • NPI 1356848121
  Medicare reassignment NPD
• App of Tennessee Ed, PLLC

  • Emergency Medicine Physician
  • Maryville, TN
  • NPI 1003230236
  Medicare reassignment
• DX Mso, PLLC

  dba Doctors Express

  • Urgent Care Clinic/Center
  • Chattanooga, TN
  • NPI 1225381148
  Medicare reassignment
• Emergency Coverage Services, PC

  • Nurse Practitioner
  • Lawrenceburg, TN
  • NPI 1053351593

  VA

  Medicare reassignment
• Emergency Medicine Services of TN, PC

  • Emergency Medicine Physician
  • Nashville, TN
  • NPI 1720785884
  Medicare reassignment
• Tennessee River Physicians, PLLC

  • Emergency Medicine Physician
  • Chattanooga, TN
  • NPI 1396282463
  Medicare reassignment
• Emergency Medicine Services of FL, LLC

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1043917180
  Medicare reassignment
• Montgomery Emergency Group, LLC

  • Emergency Medicine Physician
  • Vidalia, GA
  • NPI 1861773764
  Medicare reassignment
• Tennessee River Physicians, PLLC

  • Emergency Medicine Physician
  • Dunlap, TN
  • NPI 1699212761
  NPD
• Chattanooga Emergency Medicine PLLC

  • Emergency Care Clinic/Center
  • Hixson, TN
  • NPI 1427264126
  NPD (past)
• Covenant Medcare LLC

  • Internal Medicine Physician
  • Dunlap, TN
  • NPI 1144428780
  NPD (past)

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

• Ashland Hospital Corporation

  dba Kings Daughters Medical Center

  • General Acute Care Hospital
  • Ashland, KY
  • NPI 1851346720
  Care Compare affiliation

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1710922950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 GLENWOOD DRIVE,",
            "address_2": "SUITE E-487",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37404",
            "telephone_number": "423-697-0014",
            "fax_number": "423-648-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 DESALES AVENUE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37404",
            "telephone_number": "423-697-0014",
            "fax_number": "423-648-6280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLOCK",
        "first_name": "JASON",
        "middle_name": "S.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "PA1317",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA1317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "257502672A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "3370172",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "3664283",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "3726561",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "36642831",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TENNESSEE",
            "identifier": "4116090",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sheena Hall, CRNP
• Victoria Dixon Hall, DMD
• Emily Hallberg
• Hunter Halleen, CBC
• Edward Brian Hallock, CRNA
• Melody L Halloran, NP
• Mildred Halvorson, PT
• Sarah D. Ham, CRNA
• Brittany Taylor Hamby, FNP
• Donald Lynn Hamby, M.D.

• Physician Assistant in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.