KELLY RUTH HALL (NPI# 1912553892) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912553892 |
| Entity Type | Individual |
| Full Name | KELLY RUTH HALL |
| Credential | NP |
| Practice Address |
1680 Community Beach Rd Odin IL 62870-2100 |
| Practice Telephone | 6183226680 |
| Mailing Telephone | 6183226680 |
| Enumeration Date | 2019-08-15 |
| Last Update Date | 2019-08-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209019672 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285124057 | Kelly L Hall | Speech-Language Pathologist | 1340 W Outer 21 Rd, Arnold, MO 63010-3247 | 2018-05-16 |
| 1518417880 | Kelly Lynn Hall | Pharmacist | 7602 E Chaparral Rd, Scottsdale, AZ 85250-7754 | 2016-10-10 |
| 1043693112 | Kelly Hall | Speech-Language Pathologist | 7615 Se 19th Ave, Portland, OR 97202-6206 | 2015-07-07 |
| 1366707903 | Kelly Hall | Social Worker | 30434 Avera Creek Dr, Spring, TX 77386-3456 | 2012-07-10 |
| 1972875342 | Kelly Mcmahon Hall | Dietitian, Registered | 1122 W 18th St, Houston, TX 77008-3341 | 2012-02-01 |
| 1194955179 | Kelly Hall | Occupational Therapist | 400 Hickory St Nw Ste 302, Albany, OR 97321-1700 | 2009-07-23 |
| 1831398940 | Kelly Dailey Hall | Speech-Language Pathologist | 109 Penny Road, Greensboro, NC 27260 | 2007-07-18 |
| 1437297496 | Kelly M Hall | Respite Care | Sierra Verde Ranch 4, Lot 190, Seligman, AZ 86337-0599 | 2007-02-02 |
| 1881731917 | Kelly Hall | Nurse Practitioner | 705 Us Highway 80 W, Demopolis, AL 36732-4113 | 2007-01-30 |
| 1093740763 | Kelly Michele Hall | Chiropractor | 205 Sycamore Valley Rd W, Danville, CA 94526-3947 | 2006-07-11 |
| Street Address |
1680 COMMUNITY BEACH RD |
| City | ODIN |
| State | IL |
| Zip Code | 62870-2100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235683855 | Kd Smith | Counselor | 904 East Martin Luther King, Dr, Centralia, IL 62870 | 2016-08-11 |
| 1093917569 | Odin Grade Sch 122 | Local Education Agency (LEA) | 100 Merritt, Odin, IL 62870-0250 | 2007-06-05 |
| 1902008477 | Odin Hs 700 | Local Education Agency (LEA) | 100 Merritt, Odin, IL 62870-0250 | 2007-06-05 |
| 1477674174 | Ssc Odin Operating Company LLC | Skilled Nursing Facility | 300 Green St, Odin, IL 62870-1062 | 2007-04-02 |
| 1669023313 | Cheryl T Merchant | Speech-Language Pathologist | 300 Green St, Odin, IL 62870-1062 | 2019-09-24 |
| 1790335479 | Christilyn Wacker | Physical Therapy Assistant | 300 Green St, Odin, IL 62870-1062 | 2019-09-16 |
| 1285284000 | Brittany Leight Shuler | Physical Therapy Assistant | 300 Green St, Odin, IL 62870-1062 | 2019-09-13 |
| 1700435757 | Kathy L Reynolds | Occupational Therapy Assistant | 300 Green St, Odin, IL 62870-1062 | 2019-09-11 |
| 1265081277 | Tisha Jo Rueter | Occupational Therapy Assistant | 300 Green St, Odin, IL 62870-1062 | 2019-09-11 |
| 1497304448 | Janie Sue Zimmerman | Occupational Therapy Assistant | 300 Green St, Odin, IL 62870-1062 | 2019-09-11 |
| Find all providers in zip 62870 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538760277 | Jennifer Michelle Kennedy | Nurse Practitioner | 3006 Lakeview Dr, Metropolis, IL 62960-3119 | 2020-11-07 |
| 1881295541 | Britney Julia Durst | Nurse Practitioner | 5905 N Prospect Rd, Peoria, IL 61614-4311 | 2020-11-07 |
| 1952902884 | Julia Ann Gottschalk | Nurse Practitioner | 1979 Mcdowell Rd, Unit 103, Naperville, IL 60563 | 2020-11-06 |
| 1932700911 | Laura Ivette Portillo | Nurse Practitioner | 2727 N Marmora Ave, Chicago, IL 60639-1219 | 2020-11-05 |
| 1265033385 | Carolle M Derradji | Nurse Practitioner | 3256 W Potomac Ave, Chicago, IL 60651-2411 | 2020-11-04 |
| 1104427293 | Katie Michelle O'halloran | Nurse Practitioner | 5841 S Maryland Ave # E500, Chicago, IL 60637-1443 | 2020-11-04 |
| 1598365140 | Caitlyn Windsor | Nurse Practitioner | 24525 Grange Rd, Geneseo, IL 61254-8429 | 2020-10-31 |
| 1578163515 | Deanna Bassette | Nurse Practitioner | 243 E 31st St Apt 401, Chicago, IL 60616-5212 | 2020-10-29 |
| 1891395745 | Vrunda Shah Patel | Nurse Practitioner | 933 W Van Buren St Apt 502, Chicago, IL 60607-3583 | 2020-10-29 |
| 1346840337 | Catherine Suh | Nurse Practitioner | 1380 Marcy Ln, Wheeling, IL 60090-4422 | 2020-10-28 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on KELLY RUTH HALL.
| 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.