Individual provider Active NPI

William Henry Hall IV, MD

  • Emergency Medicine Physician
  • Elmira, NY
National Provider Identifier
1073074589
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34699 Issued in NE
Practice address
600 Roe Ave
Elmira, NY 14905-1629
Phone
(607) 737-4100
NPI assigned
Mar 27, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 34699 NE Primary

Addresses

Primary practice location

600 Roe Ave
Elmira, NY 14905-1629

Mailing address

7500 Mercy Rd
Omaha, NE 68124-2319

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220830001383 NE Practitioner - Emergency Medicine 8729462429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbus Community Hospital IncGroup PAC ID 7517954944, 86 clinicians

Practice addresses (Care Compare)

4600 38TH St
Columbus, NE 68601-1664
Phone (402) 564-7118

Hospital & facility affiliations

  • Columbus Community Hospital, Inc Hospital, Columbus, NE, CCN 280111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34699NEMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Century Physicians of Nebraska LLC Emergency Medicine Current Accepting new patients
New Century Physicians of Nebraska LLC Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients
Columbus Community Hospital Inc Emergency Medicine CurrentSince Apr 1, 2024 Accepting new patients
Columbus Community Hospital Inc CurrentSince Apr 1, 2024 Accepting new patients
Alegent Creighton Clinic Past Accepting new patients

Locations

4600 38th St
Columbus, NE 68601
Phone (402) 562-3333

16901 Lakeside Hills Ct
Omaha, NE 68130
Phone (402) 572-6500

11111 S 84th St
Papillion, NE 68046
Phone (402) 593-3000

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1073074589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 MERCY RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ROE AVE",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149051629",
            "telephone_number": "607-737-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "WILLIAM",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-27",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NE",
            "license": "34699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmira, NY

Sources for this page

Verify at the official NPI Registry.