DR. MITCHELL MAURICE HALL (NPI# 1295213114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295213114 |
| Entity Type | Individual |
| Full Name | DR. MITCHELL MAURICE HALL |
| Credential | PT, DPT |
| Practice Address |
12722 Tonkel Rd Ste 102 Fort Wayne IN 46845-8201 |
| Practice Telephone | 2607390300 |
| Practice Fax Number | 2608182299 |
| Mailing Telephone | 2607390300 |
| Mailing Fax Number | 2608182299 |
| Enumeration Date | 2018-08-02 |
| Last Update Date | 2020-06-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
05013055A | IN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | LICENSE | 05013055A | 01 |
| IN | 300017111 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568969608 | Mitchell Hall | Substance Abuse Rehabilitation Facility | 2775 State Route 39, Shelby, OH 44875-9466 | 2018-04-06 |
| 1386687960 | Mitchell Lee Hall | Registered Nurse | 809 University Blvd E, Tuscaloosa, AL 35401-2029 | 2006-06-13 |
| 1215976378 | Mitchell Frederick Hall | Emergency Medicine | 8330 Lakewood Ranch Blvd, Bradenton, FL 34202-5174 | 2006-06-05 |
| Street Address |
12722 TONKEL RD STE 102 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46845-8201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033493622 | Jonathan Evans | Physical Therapist | 12722 Tonkel Rd Ste 102, Fort Wayne, IN 46845-8201 | 2011-10-01 |
| 1245840370 | Matt C Paul | Physical Therapist | 12722 Tonkel Rd Ste 102, Fort Wayne, IN 46845-8201 | 2020-08-04 |
| 1063037174 | Katlin R Couchman | Occupational Therapist | 12722 Tonkel Rd Ste 102, Fort Wayne, IN 46845-8201 | 2020-06-15 |
| 1154943934 | Emily Ladd | Physical Therapist | 12722 Tonkel Rd Ste 102, Fort Wayne, IN 46845-8201 | 2020-05-14 |
| 1225650518 | Zachary Schmucker | Physical Therapist | 12722 Tonkel Rd Ste 102, Fort Wayne, IN 46845-8201 | 2020-05-11 |
| 1699333955 | Kirsten Allman | Physical Therapist | 12722 Tonkel Rd Ste 102, Fort Wayne, IN 46845-8201 | 2019-06-03 |
| 1063805042 | Protailored Physical Therapy LLC | Physical Therapist | 12722 Tonkel Rd Ste 102, Fort Wayne, IN 46845-8201 | 2015-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881154110 | Nancy Jean Ehmke | Clinical Nurse Specialist | 11151 Parkview Plaza Dr, Fort Wayne, IN 46845 | 2019-03-22 |
| 1043703903 | Kara Stackhouse | Nurse Practitioner | 11050 Parkview Plaza Drive, Fort Wayne, IN 46845 | 2018-06-14 |
| 1871082412 | Tara K Jellison | Pharmacist | 11109 Parkview Plaza Drive -- Attn Pharmacy, Fort Wayne, IN 46845 | 2018-05-09 |
| 1578097572 | Forefront Dermatology, S.c. | Dermatology | 4020 New Vision Drive, Fort Wayne, IN 46845 | 2017-04-17 |
| 1811437999 | Jessica Ann Lefever | Behavioral Analyst | 3898 New Vision Dr Ste D, Fort Wayne, IN 46845 | 2017-03-08 |
| 1033668041 | Bhi Home Care, Inc. | In Home Supportive Care | 820 Mill Lake Road, Fort Wayne, IN 46845 | 2016-10-03 |
| 1467814939 | Austin Wyss | Specialist/Technologist | 11130 Parkview Circle Drive, Ft. Wayne, IN 46845 | 2016-03-24 |
| 1154713584 | Ashley Whitcraft | Specialist/Technologist | 11130 Parkview Plaza Drive #4, Fort Wayne, IN 46845 | 2015-02-23 |
| 1275975682 | Lakshmi Mohan Viji Das | Internal Medicine | 11143 Parkview Plaza Dr Ste 311, Fort Wayne, IN 46845 | 2013-07-26 |
| 1336482496 | Mithun Mohana Shenoi | Colon & Rectal Surgery | 11104 Parkview Circle Drive Suite 320, Fort Wayne, IN 46845 | 2013-03-27 |
| Find all providers in zip 46845 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053977355 | Benjamin Scott England | Physical Therapist | 12912 Coldwater Rd Ste 9c, Fort Wayne, IN 46845-8870 | 2019-05-13 |
| 1033493622 | Jonathan Evans | Physical Therapist | 12722 Tonkel Rd Ste 102, Fort Wayne, IN 46845-8201 | 2011-10-01 |
| 1154338614 | Stephanie Anne Amspaugh | Physical Therapist | 302 E Jefferson Blvd, Fort Wayne, IN 46802-3114 | 2006-08-01 |
| 1174504278 | Kristine Briggs-connelly | Physical Therapist | 3844 New Vision Dr, Fort Wayne, IN 46845-1708 | 2005-11-07 |
| 1154943934 | Emily Ladd | Physical Therapist | 12722 Tonkel Rd Ste 102, Fort Wayne, IN 46845-8201 | 2020-05-14 |
| 1225650518 | Zachary Schmucker | Physical Therapist | 12722 Tonkel Rd Ste 102, Fort Wayne, IN 46845-8201 | 2020-05-11 |
| 1831740117 | Tippmann Physical Therapy, LLC | Physical Therapist | 3110 Mallard Cove Ln, Fort Wayne, IN 46804-2882 | 2019-09-26 |
| 1023481124 | Gail Ann Altekruse | Physical Therapist | 11130 Parkview Circle Dr, Fort Wayne, IN 46845-1735 | 2015-11-11 |
| 1063805042 | Protailored Physical Therapy LLC | Physical Therapist | 12722 Tonkel Rd Ste 102, Fort Wayne, IN 46845-8201 | 2015-03-14 |
| 1295716942 | Sargam Shah | Physical Therapist | 2872 E Dupont Rd, Fort Wayne, IN 46825-1669 | 2005-11-09 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46845 |
Please comment or provide details below to improve the information on DR. MITCHELL MAURICE 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.