NPIMap

Individual provider Active NPI

Herbert E Hall III, D.O.

  • Family Medicine Physician
  • Lee's Summit, MO
National Provider Identifier
1902802754
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
113305 Issued in MO
Practice address
258 NE Tudor Rd
Lees Summit, MO 64086-5696
Phone
(816) 525-8086
Fax
(816) 525-8089
NPI assigned
Jun 27, 2005
Last updated
Oct 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 13305 MO
Emergency Medicine Physician 207P00000X 113305 MO
Family Medicine Physician 207Q00000X 113305 MO Primary

Addresses

Primary practice location

258 NE Tudor Rd
Lees Summit, MO 64086-5696

Mailing address

258 NE Tudor Rd
Lees Summit, MO 64086-5696
Phone (816) 525-8086

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050906001050 MO Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 1052343597 Practice locations: Kansas City, MO; Warsaw, MO; Pleasant Hill, MO; Lees Summit, MO

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
R Franklin University of Med & Sci/Chicago Medical School, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1609 Sunchase Dr
Warsaw, MO 65355-3059
Phone (660) 438-2970

258 NE Tudor Rd
Lees Summit, MO 64086-5696
Phone (816) 525-8086

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
13305MOMDNeuromusculoskeletal Medicine & OMM Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brian K. Haith DPM PA Current Accepting new patients
Herb Hall DO Family Medicine PastSince Nov 1, 2003 Accepting new patients
Encompass Medical Group, PA Family Medicine Past Accepting new patients
Northport Health Services of Missouri, LLC Past Accepting new patients
University Health Physicians Emergency Medicine Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1902802754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 NE TUDOR RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865696",
            "telephone_number": "816-525-8086",
            "fax_number": "816-525-8089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 NE TUDOR RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865696",
            "telephone_number": "816-525-8086",
            "fax_number": "816-525-8089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "HERBERT",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "MO",
            "license": "13305",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "113305",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "113305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lee's Summit, MO

Sources for this page

Verify at the official NPI Registry.