Hall Podiatry LLC

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

License

126 Issued in OK

Legal business name

HALL PODIATRY LLC

Practice address

20 SW 132ND Terrace
Moore, OK 73170

Phone

(405) 826-0534

Fax

(405) 285-8921

NPI assigned

Sep 19, 2017

Last updated

Sep 19, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

William Dale Hall, DPM

Title

Owner

Phone

(405) 826-0534

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gordon James Bean, DPM

  • Foot & Ankle Surgery Podiatrist
  • Moore, OK
  • NPI 1255334967
  NPD (past)

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

{
    "created_epoch": "1505779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505779200000",
    "number": "1740709906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8524",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730838524",
            "telephone_number": "405-826-0534",
            "fax_number": "405-285-8921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 SW 132ND TERRACE",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "73170",
            "telephone_number": "405-826-0534",
            "fax_number": "405-285-8921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALL PODIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-19",
        "last_updated": "2017-09-19",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-826-0534",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "OK",
            "license": "126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100116430A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gynepath
• Carol Leigh Hagan, APRN-CNP
• Brenna Ann Haggerty
• Sarah Hagos
• Keri Deleigh Hale, R.D. L.D.
• Chelsea Hall, PHARMD
• Craig Mathew Hall
• Elizabeth Hall
• Irwin Hall III, PH.D
• Judith Elizabeth Hall, LCSW

• Podiatric Clinic/Center in Moore, OK
• Providers in Moore, OK by specialty
• Podiatric Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2017; 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.