Jillian Hall

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP61517210 Issued in WA

Practice address

611 31St Ave SW
Puyallup, WA 98373-3723

Phone

(253) 848-5951

NPI assigned

Dec 28, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Hill Family Medicine PCGroup PAC ID 8729980396, 67 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jhall69031@direct.tecmc.com

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.

• South Hill Family Medicine PC

  • Family Medicine Physician
  • Puyallup, WA
  • NPI 1538253331
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1703721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1891564118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 51ST CT SE",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980923929",
            "telephone_number": "253-740-4894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 31ST AVE SW",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733723",
            "telephone_number": "253-848-5951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "JILLIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-28",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61517210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breyan Haizlip, PHD, LPC
• Leslee Diane Halbert
• Aaron Hall, PT
• Elizabeth Hall, D.D.S.
• Emily Ossian Hall, MPH, PA-C
• Miles Gulliane Hall
• Sherri Lynne Hall, RD
• Cassandra C Hallstone, LMFT, MHP, CMHS
• Candis Leshawn Halsted, DNP
• Starla Halverson

• Nurse Practitioner in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.
• 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.

Verify at the official NPI Registry.