Active NPI
Michelle B. Hall, MD
- Pediatrics Physician
- Knoxville, TN
National Provider Identifier
1760601090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 45917
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1520301 | Medicaid | TN |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000045917 | TN | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeastern Emergency Physicians LLC | Emergency Medicine | Current | 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
- 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.