Anita Charlene Hall, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R702439 Issued in MS

Practice address

8990 Lorraine Rd
Gulfport, MS 39503-4176

Phone

(228) 331-3310

NPI assigned

Aug 16, 2006

Last updated

Feb 21, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Ms. Anita Charlene Fairchild Former name

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Anita Charlene Hall Aprn-BC LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gulfport, MS
  • NPI 1467950675
  Authorized official Same address or phone
• Edgewater Urgent Medical Care, LLC

  dba Edgewater Convenient Care

  • Urgent Care Clinic/Center
  • Biloxi, MS
  • NPI 1730357666
  NPD (past)
• Fusion Behavioral Health Services

  • Specialist
  • Laurel, MS
  • NPI 1104296938
  NPD (past)
• South Mississippi Health Service, Inc

  dba South Mississippi Psychiatric Group

  • Psychiatry Physician
  • Hattiesburg, MS
  • NPI 1447356902

  Family

  NPD (past)

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1801909916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8990 LORRAINE RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395034176",
            "telephone_number": "228-331-3310",
            "fax_number": "228-284-1608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8990 LORRAINE RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395034176",
            "telephone_number": "228-331-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "ANITA",
        "middle_name": "CHARLENE",
        "name_prefix": "Ms.",
        "credential": "APRN,  PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R702439",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "R702439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05250546",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891008760",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANITA",
            "last_name": "FAIRCHILD",
            "middle_name": "CHARLENE",
            "prefix": "MS.",
            "credential": "APRN, FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Taylor Hairston, DO
• David Charles Halberg
• Erin Hale, PCMHT
• Marcella A Hale, BS
• Shanon Renee Hale
• Charlaysha Hall, APRN
• Charmaine Hall, RBT
• John Jacobs Hall, M.D.
• John Reagan Hall, DMD
• Lakesha Quiana Hall, LPN

• Psychiatric/Mental Health Nurse Practitioner in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; 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.
• 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.