MEDERIC MICAH HALL (NPI# 1093836728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093836728 |
| Entity Type | Individual |
| Full Name | MEDERIC MICAH HALL |
| Credential | M.D. |
| Practice Address |
2701 Prairie Meadow Dr Iowa City IA 52242-8001 |
| Practice Telephone | 3194678059 |
| Practice Fax Number | 3193849305 |
| Mailing Telephone | 3194678059 |
| Mailing Fax Number | 3193849305 |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2014-03-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208100000X | Physical Medicine & Rehabilitation | 38299 | IA | Allopathic & Osteopathic Physicians |
| N | 208100000X | Physical Medicine & Rehabilitation | 49735 | MN | Allopathic & Osteopathic Physicians |
| Y | 2081S0010X |
Physical Medicine & Rehabilitation Specialization: Sports Medicine |
38299 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 718425000 | 05 |
| Street Address |
2701 PRAIRIE MEADOW DR |
| City | IOWA CITY |
| State | IA |
| Zip Code | 52242-8001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750354031 | Matthew Richard Doyle | Specialist/Technologist | 2701 Prairie Meadow Dr, Iowa City, IA 52242-8001 | 2006-02-08 |
| 1902425259 | Katherine Ellen Ryan | Physical Therapy Assistant | 2701 Prairie Meadow Dr, Iowa City, IA 52242-8001 | 2020-04-15 |
| 1972122463 | Kolleen Casey Shields | Physical Therapist | 2701 Prairie Meadow Dr, Iowa City, IA 52242-8001 | 2020-04-14 |
| 1750900387 | Auriel Luna | Physical Medicine & Rehabilitation | 2701 Prairie Meadow Dr, Iowa City, IA 52242-8001 | 2020-04-14 |
| 1174142780 | Michael Shaffer | Physical Therapist | 2701 Prairie Meadow Dr, Iowa City, IA 52242-8001 | 2020-04-14 |
| 1437778040 | Jon Raymond Lueth | Physical Therapist | 2701 Prairie Meadow Dr, Iowa City, IA 52242-8001 | 2020-04-14 |
| 1134754500 | Rebecca Marie Mallon | 2701 Prairie Meadow Dr, Iowa City, IA 52242-8001 | 2020-03-06 | |
| 1518590520 | William R Saul | Specialist/Technologist | 2701 Prairie Meadow Dr, Iowa City, IA 52242-8001 | 2020-02-18 |
| 1528477239 | Anthony Pennuto | Specialist/Technologist | 2701 Prairie Meadow Dr, Iowa City, IA 52242-8001 | 2014-08-06 |
| 1770998791 | Jema Swanson | Specialist/Technologist | 2701 Prairie Meadow Dr, Iowa City, IA 52242-8001 | 2014-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033738679 | Shannon Louise Miers | Physical Therapist | Ui Sports Medicine (iosmr), 2701 Prairie Meadow Drive, Iowa City, IA 52242 | 2020-04-14 |
| 1821624230 | Victoria Troesch | Student in an Organized Health Care Education/Training Program | 375 Newton Rd, Iowa City, IA 52242 | 2020-03-17 |
| 1891338539 | Kira Ann Hennes Blum | Dietitian, Registered | 930 Evashevski Dr., Jacobson Building, Iowa City, IA 52242 | 2019-10-25 |
| 1407330483 | Kristin L Heider | Psychologist | 616 E Bloomington Street, Iowa City, IA 52242 | 2018-09-17 |
| 1447738398 | Allison Kral | Dietitian, Registered | 200 Hawkins Dr. W146 Gh, Iowa City, IA 52242 | 2018-08-02 |
| 1528544780 | Abigail Lynne Schiltz | Physician Assistant | 200 Hawkins Dr 01290a Pfp, Iowa City, IA 52242 | 2018-07-11 |
| 1710474259 | Bashar H. H. Abuqayas | Hospitalist | 200 Hawkins Dr, Se 636 Gh, Uihc-internal Medicine, Iowa City, IA 52242 | 2018-04-19 |
| 1023547395 | Tyler Quist | Internal Medicine | 200 Hawkins Dr Dept of Ophthalmology, Iowa City, IA 52242 | 2017-06-08 |
| 1972962371 | Angeleah Korin Whitlatch | Social Worker | 100 Hawking Drive, Iowa City, IA 52242 | 2016-02-15 |
| 1649667734 | Jennie Sertterh | Specialist/Technologist | 1 Elliot Drive, S181 Carver Hawkeye Arena, Iowa City, IA 52242 | 2015-04-16 |
| Find all providers in zip 52242 | ||||
| Taxonomy Code | 2081S0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Sports Medicine |
| A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise. |
| Notes: Source: American Board of Medical Specialties, 2009. www.abms.org [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750900387 | Auriel Luna | Physical Medicine & Rehabilitation | 2701 Prairie Meadow Dr, Iowa City, IA 52242-8001 | 2020-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093369589 | Jacob Canright | Physical Medicine & Rehabilitation | 3200 W Kimberly Rd, Davenport, IA 52806-3059 | 2019-08-01 |
| 1164962890 | Rachel Marie Schmidt | Physical Medicine & Rehabilitation | 2700 College Rd, Council Bluffs, IA 51503-1057 | 2017-02-28 |
| 1871046466 | Kelli Ann Jensen | Physical Medicine & Rehabilitation | 203 N 5th St, West Branch, IA 52358-9616 | 2016-07-29 |
| 1194108209 | Harbor View Medical Services LLC | Physical Medicine & Rehabilitation | 6151 Thornton Ave Ste 200, Des Moines, IA 50321-2413 | 2015-07-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.