Active NPI
Shannon D Dale Hall, CRNA
- Certified Registered Nurse Anesthetist
- New Haven, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 20635
- Practice address
- 500 College St
Yale New Haven Hospital
New Haven, CT 06511-8962 - Phone
- (203) 432-2700
- NPI assigned
- Jul 29, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 071173 | TN | |
| Certified Registered Nurse Anesthetist | 367500000X | 003790 | CT | |
| Certified Registered Nurse Anesthetist | 367500000X | 20635 | SC | Primary |
Addresses
Primary practice location
500 College St
Yale New Haven Hospital
New Haven, CT 06511-8962
Mailing address
640 Urlacher Dr
Murfreesboro, TN 37129-8998
Phone (615) 796-0057
Other practice location 1
1330 Taylor St
Columbia, SC 29201-2915
Phone (803) 296-5010
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | SC | |
| 74007634 | Medicaid | KY | |
| 3634996 | Medicaid | TN | |
| 4072296 | Other | TN | BCBS NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, SC
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Medical Park Blvd
Bristol, TN 37620-7430
Phone (423) 390-0451
Hospital & facility affiliations
- Wellmont Holston Valley Medical Center
- Wellmont Bristol Regional Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10941 | TN | MD | Physical Therapist |
| 10961 | TN | MD | Pediatric Physical Therapist |
| 20635 | SC | MD | Certified Registered Nurse Anesthetist |
| 071173 | TN | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Tennessee Ambulatory Surgery Center LLC | Current | Accepting new patients | |
| Paragon Anesthesia PC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Prisma Health-Upstate | Current | Accepting new patients | |
| Prisma Health-Upstate | Current | Accepting new patients | |
| American Anesthesiology of Tennessee, P.C. | Current | Accepting new patients | |
| Greenville Health System | Current | Accepting new patients | |
| Pathology Associates of Greenville PA | Current | Accepting new patients | |
| Prisma Health-Midlands | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Prisma Health-Midlands | Current | Accepting new patients | |
| Greenville Health System | Current | Accepting new patients | |
| Prisma Health-Upstate | Current | Accepting new patients | |
| Prisma Health-Midlands | Current | Accepting new patients | |
| Singing River Health System | Past | Accepting new patients | |
| Anesthesia Associates of New London, PC | Past | Accepting new patients |
Locations
22725 US Highway 76
Clinton, SC 29325
Phone (864) 833-9100
1330 Taylor St
Columbia, SC 29201
Phone (803) 296-5137
701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030
100 Augusta St
Greenville, SC 29601
Phone (864) 455-2600
1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306
175 Patewood Dr
Greenville, SC 29615
Phone (864) 797-1000
200 Patewood Dr
Bldg A
Greenville, SC 29615
Phone (864) 454-2604
830 S Buncombe Rd
Greer, SC 29650
Phone (864) 797-8000
298 Memorial Dr
Seneca, SC 29672
Phone (864) 482-3100
729 SE Main St
Simpsonville, SC 29681
Phone (864) 271-8647
807 N Main St
Travelers Rst, SC 29690
Phone (864) 834-5132
1 Medical Park Blvd
Ste 210E
Bristol, TN 37620
Phone (423) 224-4000
1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451
130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150
10415 Wallace Alley St
Kingsport, TN 37663
Phone (423) 390-0451
9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040
Organizations & group practices 14
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.
-
- Anesthesiology Physician
- Kingsport, TN
- NPI 1538174974
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Knoxville, TN
- NPI 1609822998
-
- General Acute Care Hospital
- Greenville, SC
- NPI 1568532513
-
- General Acute Care Hospital
- Columbia, SC
- NPI 1205889458
-
- General Acute Care Hospital
- Greenville, SC
- NPI 1649726738
-
- Ambulatory Surgical Clinic/Center
- Johnson City, TN
- NPI 1659360071
-
- Emergency Medicine Physician
- Seneca, SC
- NPI 1033580444
-
- Anatomic Pathology & Clinical Pathology Physician
- Greenville, SC
- NPI 1831151976
-
- Certified Registered Nurse Anesthetist
- Columbia, SC
- NPI 1003327792
Nurse Anesthetist, Certified Registered
-
- General Acute Care Hospital
- Sumter, SC
- NPI 1326043548
-
- Medically Fragile Infants and Children Day Care
- Greenville, SC
- NPI 1811439649
-
- General Acute Care Hospital
- Easley, SC
- NPI 1851847974
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bristol, TN
- NPI 1124058615
-
- General Acute Care Hospital
- Kingsport, TN
- NPI 1487690400
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640044800000",
"number": "1821098930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "640 URLACHER DR",
"city": "MURFREESBORO",
"state": "TN",
"postal_code": "371298998",
"telephone_number": "615-796-0057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 COLLEGE ST",
"address_2": "YALE NEW HAVEN HOSPITAL",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065118962",
"telephone_number": "203-432-2700"
}
],
"practiceLocations": [
{
"address_1": "1330 Taylor St",
"address_purpose": "LOCATION",
"city": "Columbia",
"state": "SC",
"postal_code": "292012915",
"country_code": "US",
"telephone_number": "803-296-5010",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HALL",
"first_name": "SHANNON D",
"middle_name": "DALE",
"name_prefix": "Mr.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-29",
"last_updated": "2021-12-21",
"certification_date": "2021-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TN",
"license": "071173",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "CT",
"license": "003790",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "SC",
"license": "20635",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "74007634",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3634996",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NUMBER",
"identifier": "4072296",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; 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.