Individual provider Active NPI

Michelle B. Hall, MD

  • Pediatrics Physician
  • Knoxville, TN
National Provider Identifier
1760601090
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
45917 Issued in TN
Practice address
2018 Clinch Ave
Knoxville, TN 37916-2301
Phone
(865) 541-8660
Fax
(865) 541-8713
NPI assigned
Apr 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0000045917 TN
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 0000045917 TN
Pediatrics Physician 208000000X 45917 TN Primary

Addresses

Primary practice location

2018 Clinch Ave
Knoxville, TN 37916-2301

Mailing address

P.O. Box 15004
Knoxville, TN 37901-5004
Phone (865) 541-8660

Other identifiers 1

IdentifierTypeStateIssuer
1520301MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20240410002755 TN Practitioner - Pediatric Medicine 5799857256 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0000045917TNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Mar 5, 2024 Accepting new patients

Locations

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

265 Brookview Centre Way
Ste 203
Knoxville, TN 37919
Phone (865) 500-1254

2018 Clinch Ave
Knoxville, TN 37916
Phone (865) 541-8000

Interoperability endpoints

  • Direct secure messaging: michelle.hall.1@15829.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1760601090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 15004",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379015004",
            "telephone_number": "865-541-8660",
            "fax_number": "865-541-8713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 CLINCH AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162301",
            "telephone_number": "865-541-8660",
            "fax_number": "865-541-8713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "MICHELLE",
        "middle_name": "B.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "0000045917",
            "primary": false
        },
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "TN",
            "license": "0000045917",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "45917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1520301",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.