Individual provider Active NPI

Tillman Hall, CRNA

  • Certified Registered Nurse Anesthetist
  • Dothan, AL
National Provider Identifier
1972076859
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-148881 Issued in AL
Practice address
4370 W Main St
Dothan, AL 36305-1056
Phone
(334) 793-5000
NPI assigned
Jan 3, 2019
Last updated
Jan 3, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1-148881 AL Primary

Addresses

Primary practice location

4370 W Main St
Dothan, AL 36305-1056

Mailing address

105 Porch CT
Dothan, AL 36305-5803

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190211002408 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 3274871611 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dothan Anesthesiology Associates PCGroup PAC ID 2769417583, 40 clinicians
Flowers HB Medical Services LLCGroup PAC ID 6305290990, 139 clinicians

Practice addresses (Care Compare)

4370 W Main St
Dothan, AL 36305-1056
Phone (334) 794-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Geneva County Healthcare Authority Inc Nurse Anesthetist, Certified Registered CurrentSince Jun 13, 2024 Accepting new patients
Dothan Anesthesiology Associates PC CurrentSince Jan 1, 2019 Accepting new patients
Geneva County Healthcare Authority, Inc. CurrentSince Jun 13, 2024 Accepting new patients
Flowers HB Medical Services LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 15, 2025 Accepting new patients

Locations

4370 W Main St
Dothan, AL 36305
Phone (256) 332-1611

1200 W Maple Ave
Geneva, AL 36340
Phone (334) 684-3655

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1546473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1972076859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 PORCH CT",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363055803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 W MAIN ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051056",
            "telephone_number": "334-793-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "TILLMAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-03",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-148881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.