Active NPI
Jeffrey Timothy Hall, M.D.
- Diagnostic Radiology Physician
- Boise, ID
National Provider Identifier
1831146034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- M5352
- Practice address
- 1055 N Curtis Rd
Boise, ID 83706-1309 - Phone
- (208) 367-2161
- NPI assigned
- May 31, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | M5352 | ID | Primary |
Addresses
Primary practice location
1055 N Curtis Rd
Boise, ID 83706-1309
Mailing address
PO Box 9649
Boise, ID 83707-4649
Phone (208) 472-8100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003751000 | Medicaid | ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M5352 | ID | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gooding County Hospital District | Past | Accepting new patients | |
| Gem State Radiology LLP | Diagnostic Radiology | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Diagnostic Radiology Physician
- Boise, ID
- NPI 1083661508
-
- Critical Access Hospital
- Gooding, ID
- NPI 1295769537
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318464000000",
"number": "1831146034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9649",
"city": "BOISE",
"state": "ID",
"postal_code": "837074649",
"telephone_number": "208-472-8100",
"fax_number": "208-472-8172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 N CURTIS RD",
"city": "BOISE",
"state": "ID",
"postal_code": "837061309",
"telephone_number": "208-367-2161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "JEFFREY",
"middle_name": "TIMOTHY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-31",
"last_updated": "2011-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "ID",
"license": "M5352",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003751000",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.