Individual provider Active NPI

Tina D Hall, FNP

  • Nurse Practitioner
  • Morristown, TN
National Provider Identifier
1942287743
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
6650 Issued in TN
Practice address
1050 Freshour St
Ste a
Morristown, TN 37813-2210
Phone
(423) 581-1479
Fax
(423) 586-7488
NPI assigned
Dec 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 6650 TN Primary

Addresses

Primary practice location

1050 Freshour St
Ste a
Morristown, TN 37813-2210

Mailing address

1050 Freshour St
Ste a
Morristown, TN 37813-2210
Phone (423) 581-1479

Other identifiers 2

IdentifierTypeStateIssuer
4066177OtherTNBLUE CROSS BLUE SCHEILD
1513604MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hall.tina@covenanthealth.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20111110000398 TN Practitioner - Nurse Practitioner 3779761218 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
East Tennessee State University Quillen College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians

Practice addresses (Care Compare)

111 Clyde St
Loudon, TN 37774-1600
Phone (865) 458-1554

3614 W Andrew Johnson Hwy
Morristown, TN 37814-3602
Phone (423) 586-9495

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc. CurrentSince Jan 1, 2013 Accepting new patients
East Tennessee Pathology, PLLC Current Accepting new patients
Covenant Medical Group, Inc CurrentSince Jan 1, 2013 Accepting new patients

Locations

Dept 888179
Knoxville, TN 37995

1400 Centerpoint Blvd
Ste 160
Knoxville, TN 37932
Phone (865) 374-5200

111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554

908 W 4th North St
Morristown, TN 37814
Phone (423) 492-9000

1621 W Morris Blvd
Ste B
Morristown, TN 37813
Phone (423) 492-6700

1050 Freshour St
Ste A
Morristown, TN 37813
Phone (423) 581-1479

Interoperability endpoints

  • Direct secure messaging: hall.tina@covenanthealth.cernerdirect.com

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 1

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": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1942287743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 FRESHOUR ST",
            "address_2": "STE A",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378132210",
            "telephone_number": "423-581-1479",
            "fax_number": "423-586-7488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 FRESHOUR ST",
            "address_2": "STE A",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378132210",
            "telephone_number": "423-581-1479",
            "fax_number": "423-586-7488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "TINA",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-22",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "6650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SCHEILD",
            "identifier": "4066177",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1513604",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hall.tina@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1050 Freshour St",
            "address_2": "Ste A",
            "city": "Morristown",
            "state": "TN",
            "country_code": "US",
            "postal_code": "378132210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Morristown, TN

Sources for this page

Verify at the official NPI Registry.