Individual provider Active NPI

Anne V Hall, PA

  • Physician Assistant
  • Santa Maria, CA
National Provider Identifier
1821080060
Registry record updated Dec 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
52181 Issued in CA
Practice address
300 S Stratford Ave
Santa Maria, CA 93454-5903
Phone
(805) 739-3863
NPI assigned
Aug 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 003456 NY
Physician Assistant 363A00000X 52181 CA Primary

Addresses

Primary practice location

300 S Stratford Ave
Santa Maria, CA 93454-5903

Mailing address

1400 E. Church Street
Attention- Medical Staff Office
Santa Maria, CA 93454
Phone (805) 739-3954

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2364TNMDChiropractor
003456-1NYMDSpeech-Language Pathologist
52181CAMDPhysician Assistant
003456CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Jun 16, 2014 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Jun 16, 2014 Accepting new patients
Sonora Community Hospital CurrentSince May 27, 2016 Accepting new patients

Locations

193 Fairview Ln
Sonora, CA 95370
Phone (209) 536-5100

Organizations & group practices 3

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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1821080060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E. CHURCH STREET",
            "address_2": "ATTENTION- MEDICAL STAFF OFFICE",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "93454",
            "telephone_number": "805-739-3954",
            "fax_number": "805-739-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S STRATFORD AVE",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934545903",
            "telephone_number": "805-739-3863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "ANNE",
        "middle_name": "V",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-15",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "003456",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "52181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.