TIMOTHY WAYNE HALL (AGACNP-BC, FNP-BC) – Family Nurse Practitioner, NPI 1154761336

TIMOTHY WAYNE HALL (AGACNP-BC, FNP-BC) is a healthcare provider. based in Wyoming, Michigan. specializing in NURSE PRACTITIONER. They hold the professional credentials AGACNP-BC, FNP-BC. They hold a License No. 4704199433 (MI). The NPI Number for TIMOTHY WAYNE HALL (AGACNP-BC, FNP-BC) is 1154761336

Main info

Male
13 Years Of Experience
Accepts Medicare Assignment
Name
TIMOTHY WAYNE HALL (AGACNP-BC, FNP-BC)
NPI
1154761336
Phone
(616) 252-3243
Address
5900 BYRON CENTER AVE SW
Enumeration Date
2 July 2013
Last Update Date
7 March 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6166855600
Graduation Year
2013 (13 years ago)
PAC ID
6608001524
Group Practice PAC ID
4082807961
Professional Enrollment ID
I20131031001202
Address ID
MI495034608GR250XXSEXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:12State licenses:1Digital endpointsOther names

8,106 NURSE PRACTITIONER in MI

Provider Addresses for TIMOTHY WAYNE HALL (AGACNP-BC, FNP-BC)

  • 5900 BYRON CENTER AVE SW

    MEDICAL ADMINISTRATION

    WYOMING, MI 495199606

    Phone: (616) 252-3243

    Fax: (616) 252-0260

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2013-10-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20131031001202INurse PractitionerMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49519)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4082807961View full group profile

Reviews

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Frequently asked questions

Can I cross-check TIMOTHY WAYNE HALL (AGACNP-BC, FNP-BC) using NPI 1154761336?
NPI 1154761336 belongs to TIMOTHY WAYNE HALL (AGACNP-BC, FNP-BC); compare other details if you need extra assurance.
Is TIMOTHY WAYNE HALL (AGACNP-BC, FNP-BC) still an active registrant?
TIMOTHY WAYNE HALL (AGACNP-BC, FNP-BC) carries an active NPI according to the public dataset.
How would a patient describe TIMOTHY WAYNE HALL (AGACNP-BC, FNP-BC)'s focus?
For TIMOTHY WAYNE HALL (AGACNP-BC, FNP-BC), the primary taxonomy reads as Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What practice footprint exists for TIMOTHY WAYNE HALL (AGACNP-BC, FNP-BC)?
Travel planning: use Wyoming, Michigan as the reference point for TIMOTHY WAYNE HALL (AGACNP-BC, FNP-BC), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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