Nancy L Hall, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10002187 Issued in IN

Practice address

4466 W Bristol Rd
Flint, MI 48507-3170

Phone

(810) 733-1200

Fax

(810) 733-3130

NPI assigned

Apr 19, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Parkview Health System Inc

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1932130952
  NPD (past)

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484697600000",
    "number": "1801013065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3926 NEW VISION DR",
            "address_2": "BLDG H",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451712",
            "telephone_number": "260-266-8213",
            "fax_number": "260-458-5658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4466 W BRISTOL RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073170",
            "telephone_number": "810-733-1200",
            "fax_number": "810-733-3130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "NANCY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2017-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10002187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 2 NPI",
            "identifier": "1215930490",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRP MEDICARE NUMBER",
            "identifier": "0N45090",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Marie Hall, BA
• Janese Hall
• Jey Hall, LLMSW
• June Marie Hall, L.M.S.W.
• Mark Hall, RN
• Nicholas Hall, DO
• Susan Lynn Hall
• Tamara Hall
• Tyaira Hall
• Tyteanna Hall

• Physician Assistant in Flint, MI
• Providers in Flint, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.