Individual provider Active NPI

Randall Stanton Hall, D.O.

  • Cardiovascular Disease Physician
  • Keller, TX
National Provider Identifier
1902808439
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
L3673 Issued in TX
Practice address
601 S Main St Ste 200
Keller, TX 76248-7028
Phone
(817) 912-8060
Fax
(817) 912-8070
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Cardiology Physician 207UN0901X L3673 TX
Cardiovascular Disease Physician 207RC0000X L3673 TX Primary

Addresses

Primary practice location

601 S Main St Ste 200
Keller, TX 76248-7028

Mailing address

601 S Main St Ste 200
Suite 200
Keller, TX 76248-7028
Phone (817) 912-8060

Other identifiers 3

IdentifierTypeStateIssuer
150872302MedicaidTX
150872301MedicaidTX
8CA479OtherTXBCBS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rhall225439@direct.sw.org

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090713000307 TX Practitioner - Cardiovascular Disease (Cardiology) 2860544467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of North Texas HSC, College of Osteopathic Med, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

1400 8TH Ave
Fort Worth, TX 76104-4110

1650 W College St
Grapevine, TX 76051-3565
Phone (817) 388-3440

2020 W Hwy 114
Suite 200
Grapevine, TX 76051-8648
Phone (817) 416-7214

2020 W State Hwy 114 120
Baylor Family Med Ctr Grapevine
Grapevine, TX 76051-8648
Phone (817) 912-8300

3333 Colorado Blvd
Denton, TX 76210-6817
Phone (940) 381-2199

4001 Worth St
Dallas, TX 75246-1608

5408 Colleyville Blvd
Colleyville, TX 76034-5833
Phone (817) 498-9920

6000 W Spring Creek Pkwy
220 Baylor Scott and White Cardiovascular Con
Plano, TX 75024-3578
Phone (469) 800-4400

821 N Coleman St
Suite 100
Prosper, TX 75078-2339
Phone (469) 800-5200

Hospital & facility affiliations

  • Baylor Scott & White Medical Center Grapevine Hospital, Grapevine, TX, CCN 450563
  • The Heart Hospital Baylor Denton Hospital, Denton, TX, CCN 450893
  • Baylor Scott and White All Saints Medical Center Hospital, Fort Worth, TX, CCN 450137
  • Baylor Scott & White the Heart Hospital Plano Hospital, Plano, TX, CCN 670025
  • Texas Health Harris Methodist Hurst-Euless-Bedford Hospital, Bedford, TX, CCN 450639

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L3673TXMDNuclear Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Cardiovascular Disease Current Accepting new patients
Healthtexas Provider Network CurrentSince May 5, 2014 Accepting new patients
Healthtexas Provider Network CurrentSince May 5, 2014 Accepting new patients
Healthtexas Provider Network Past Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

1650 W College St
Grapevine, TX 76051
Phone (817) 329-2523

2020 W State Highway 114
Ste 200
Grapevine, TX 76051
Phone (817) 416-7214

620 S Main St
Ste 240
Keller, TX 76248
Phone (817) 912-8150

601 S Main St
Ste 200
Keller, TX 76248
Phone (682) 549-3311

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Baylor Scott & White the Heart Hospital - PlanoPlano, TX, CCN 670025 Hospital General Partnership Interest Jan 3, 2024
Texas Health Heart & Vascular HospitalArlington, TX, CCN 670071 Hospital 5% Or Greater Direct Ownership Interest
General Partnership Interest
Jun 6, 2005
Jun 6, 2005
Baylor Scott & White the Heart Hospital - DentonDenton, TX, CCN 450893 Hospital General Partnership Interest Jan 3, 2024
Baylor Scott & White the Heart Hospital RehabilitationDenton, TX, CCN 67T347 Hospital General Partnership Interest Nov 1, 2024
Baylor Scott & White the Heart Hospital - CorinthDenton, TX, CCN 670347 Hospital General Partnership Interest Nov 1, 2024

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1902808439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S MAIN ST STE 200",
            "address_2": "SUITE 200",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762487028",
            "telephone_number": "817-912-8060",
            "fax_number": "817-912-8070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S MAIN ST STE 200",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762487028",
            "telephone_number": "817-912-8060",
            "fax_number": "817-912-8070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "RANDALL",
        "middle_name": "STANTON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "TX",
            "license": "L3673",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "L3673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150872302",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150872301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8CA479",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rhall225439@direct.sw.org",
            "affiliation": "N",
            "address_1": "620 S Main St Ste 240",
            "city": "Keller",
            "state": "TX",
            "country_code": "US",
            "postal_code": "762485009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Keller, TX

Sources for this page

Verify at the official NPI Registry.