Individual provider Active NPI

Angela Hall, D.C

  • Chiropractor
  • Poynette, WI
National Provider Identifier
1720194418
Registry record updated Jan 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4142-012 Issued in WI
Practice address
110 N Main St
Poynette, WI 53955-9329
Phone
(608) 635-8915
Fax
(608) 635-8901
NPI assigned
Aug 22, 2006
Last updated
Jan 18, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4142-012 WI Primary

Addresses

Primary practice location

110 N Main St
Poynette, WI 53955-9329

Mailing address

PO Box 398
Poynette, WI 53955-0398
Phone (608) 635-8915

Other identifiers 1

IdentifierTypeStateIssuer
38962200MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051007000048 WI Practitioner - Chiropractic 3971528100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1000 Links Dr
Suite 1
Poynette, WI 53955-8323
Phone (608) 635-8915

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4142-012WIMDChiropractor
4142WIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Valley Eye Care PLC PastSince Sep 1, 2013 Accepting new patients
Marengo Chiropractic & Wellness Center, PC Chiropractor PastSince Jul 11, 2006 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358467200000",
    "number": "1720194418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 398",
            "city": "POYNETTE",
            "state": "WI",
            "postal_code": "539550398",
            "telephone_number": "608-635-8915",
            "fax_number": "608-635-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N MAIN ST",
            "city": "POYNETTE",
            "state": "WI",
            "postal_code": "539559329",
            "telephone_number": "608-635-8915",
            "fax_number": "608-635-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "ANGELA",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2013-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4142-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38962200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poynette, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.