Active NPI
Edward Jason Hall, DO
- Family Medicine Physician
- Greenville, MI
National Provider Identifier
1922072446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 5101014725
- Practice address
- 1014 E Washington
Greenville, MI 48838 - Phone
- (616) 754-7145
- Fax
- (616) 754-7110
- NPI assigned
- Feb 13, 2006
- 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 | 5101014725 | MI | Primary |
Addresses
Primary practice location
1014 E Washington
Greenville, MI 48838
Mailing address
PO Box 730
406 E Elm St
Carson City, MI 48811
Phone (989) 584-3131
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4592581 | Medicaid | MI | |
| 080195443 | Other | MI | RAILROAD MEDICARE PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101014725 | MI | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259798400000",
"number": "1922072446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 730",
"address_2": "406 E ELM ST",
"city": "CARSON CITY",
"state": "MI",
"postal_code": "48811",
"telephone_number": "989-584-3131",
"fax_number": "989-584-6734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1014 E WASHINGTON",
"city": "GREENVILLE",
"state": "MI",
"postal_code": "48838",
"telephone_number": "616-754-7145",
"fax_number": "616-754-7110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "EDWARD",
"middle_name": "JASON",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-13",
"last_updated": "2009-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "5101014725",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4592581",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE PTAN",
"identifier": "080195443",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.