Roger William Hall, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1751TX Issued in WA

Practice address

10217 19TH Ave SE Ste 102
Everett, WA 98208-4266

Phone

(425) 316-9400

Fax

(425) 316-8820

NPI assigned

Nov 14, 2006

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

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Olympia Vision Clinic and Contact Lens Center, PLLC

  • Optometrist
  • Olympia, WA
  • NPI 1962544692
  Medicare reassignment NPD

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266883200000",
    "number": "1932271921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10217 19TH AVE SE STE 102",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982084266",
            "telephone_number": "425-316-9400",
            "fax_number": "425-316-8820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10217 19TH AVE SE STE 102",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982084266",
            "telephone_number": "425-316-9400",
            "fax_number": "425-316-8820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "ROGER",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2010-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1751TX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2024818",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Hall
• Jonathan Bergh Hall, M.D.
• Kylie Hall, RBT
• Lena Hall, LMP
• Melanie Paul Hall, BA
• Simone Hall, PMHNP-BC, ARNP
• Timothy Hall, CRNA
• Alexia Stephanie Halle
• Melanie Anne Haller, RNFA
• Ralph T. Haller, M.D.

• Optometrist in Everett, WA
• Providers in Everett, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.