Gregory Bruno Hall, MD FACS

Primary specialty

SpecialistTaxonomy code 174400000X

License

9600335 Issued in NC

Practice address

150 Fairview Rd
Suite 300
Mooresville, NC 28117-9504

Phone

(704) 664-6677

Fax

(704) 663-1009

NPI assigned

Aug 23, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Lakeside Surgical Associates, PA

  • Specialist
  • Mooresville, NC
  • NPI 1487709713
  Authorized official Same address or phone

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285286400000",
    "number": "1710970025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 FAIRVIEW RD",
            "address_2": "SUITE 300",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179504",
            "telephone_number": "704-664-6677",
            "fax_number": "704-663-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 FAIRVIEW RD",
            "address_2": "SUITE 300",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179504",
            "telephone_number": "704-664-6677",
            "fax_number": "704-663-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "GREGORY",
        "middle_name": "BRUNO",
        "name_prefix": "Dr.",
        "credential": "MD FACS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2010-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "9600335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8938320",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexa Victoria Haggard, DPT
• Taylor Haines
• Ruth Hakobian
• Jessica Hughes Halapy, MS OTR/L
• Tricia Ann Hall Chacchia, MA CCC-SLP
• Kimberly M Hall, MBA, MFTA
• Samantha Hallowell, FNP-CC
• Brennah Halsey
• Claire Halterman
• Jaimee Lynn Halupa, LMHCA

• Specialist in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2010; 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.