Individual provider Active NPI

Kristine Marie Hall, PT

  • Physical Therapist
  • Dakota Dunes, SD
National Provider Identifier
1790777431
Registry record updated Sep 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
004453 Issued in IA
Practice address
871 E Sawgrass TRL
Dakota Dunes, SD 57049-5198
Phone
(712) 574-4470
NPI assigned
Aug 18, 2005
Last updated
Sep 8, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1284 NV
Physical Therapist 225100000X 004453 IA Primary
Physical Therapist 225100000X 0986 SD

Addresses

Primary practice location

871 E Sawgrass TRL
Dakota Dunes, SD 57049-5198

Mailing address

871 E Sawgrass TRL
Dakota Dunes, SD 57049-5198
Phone (712) 574-4470

Other identifiers 1

IdentifierTypeStateIssuer
100503513MedicaidNV

Other names 1

  • Kristine Marie Jones Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151022002579 SD Practitioner - Physical Therapist in Private Practice 7012980360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hall Physical Therapy LLCGroup PAC ID 1557652021, 2 clinicians

Practice addresses (Care Compare)

370 W Anchor Dr
Suite 214
Dakota Dunes, SD 57049-5153
Phone (712) 360-4697

871 E Sawgrass TRL
Dakota Dunes, SD 57049-5198

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004453IAMDPhysical Therapist
1284NVMDPhysical Therapist
0986SDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hall Physical Therapy, LLC Physical Therapist CurrentSince May 13, 2016 Accepting new patients
Chynoweth Hill and Leavitt LLC Physical Therapist Past Accepting new patients
For Life Human Performance Inc Physical Therapist PastSince Jun 3, 2015 Accepting new patients
Chynoweth Hill and Leavitt LLC Past Accepting new patients

Locations

370 W Anchor Dr
Ste 214
Dakota Dunes, SD 57049
Phone (605) 360-4697

Organizations & group practices 4

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": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441670400000",
    "number": "1790777431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "871 E SAWGRASS TRL",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "570495198",
            "telephone_number": "712-574-4470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "871 E SAWGRASS TRL",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "570495198",
            "telephone_number": "712-574-4470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "KRISTINE",
        "middle_name": "MARIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2015-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "1284",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "004453",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SD",
            "license": "0986",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100503513",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINE",
            "last_name": "JONES",
            "middle_name": "MARIE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dakota Dunes, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2015; 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.