Active NPI
Stephen Lynn Halla, D.O.
- Family Medicine Physician
- Indianapolis, IN
National Provider Identifier
1841453974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- TEP - PERMIT NO. 589
- Practice address
- 1481 W 10TH St
Indianapolis, IN 46202-2803 - Phone
- (317) 554-0000
- NPI assigned
- Jul 9, 2008
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | TEP - PERMIT NO. 589 | NE | Primary |
Addresses
Primary practice location
1481 W 10TH St
Indianapolis, IN 46202-2803
Mailing address
55TH MDG/SGHC Attn: Credentials
2501 Capehart Road
Offutt Afb, NE 68113-2160
Phone (402) 294-2448
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220923000422 | TX | Order and Referring Only - Family Practice | 2769867977 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TEP - PERMIT NO. 589 | NE | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686182400000",
"number": "1841453974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55TH MDG/SGHC ATTN: CREDENTIALS",
"address_2": "2501 CAPEHART ROAD",
"city": "OFFUTT AFB",
"state": "NE",
"postal_code": "681132160",
"telephone_number": "402-294-2448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1481 W 10TH ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462022803",
"telephone_number": "317-554-0000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALLA",
"first_name": "STEPHEN",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-09",
"last_updated": "2023-06-08",
"certification_date": "2023-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NE",
"license": "TEP - PERMIT NO. 589",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.