Jacob W Hall, PHARMD

Primary specialty

PharmacyTaxonomy code 333600000X

License

019523 Issued in KY

Practice address

3040 Dolphin Dr
Elizabethtown, KY 42701-7135

Phone

(270) 737-4578

NPI assigned

Dec 30, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1577664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1891334447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 S 6TH ST",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400041132",
            "telephone_number": "502-827-9994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 DOLPHIN DR",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427017135",
            "telephone_number": "270-737-4578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "JACOB",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-30",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "KY",
            "license": "019523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Jacob.hall2@stores.kroger.com",
            "affiliation": "N",
            "address_1": "3040 Dolphin Dr",
            "city": "Elizabethtown",
            "state": "KY",
            "country_code": "US",
            "postal_code": "427017135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lauretta H Haley
• Hall and Associates
• Brent Hall
• Donna Barbee Hall, MFTA
• Helyn Hall
• Jay Anthony Hall, LCSW, SAP
• Jerry David Hall Jr.
• Joseph Eugene Hall, LMFT, LPCC, CADC
• Karen Hall
• Kari Bonnett Hall, MSCCCSLP

• Pharmacy in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Pharmacy in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.