NPIMap

Individual provider Active NPI

Shantall Viridiana Hall, D.O.

  • Emergency Medicine Physician
  • Glendale, AZ
National Provider Identifier
1174759807
Registry record updated Aug 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
005194 Issued in AZ
Practice address
5555 W Thunderbird Rd
Glendale, AZ 85306-4622
Phone
(602) 588-5555
NPI assigned
Jun 9, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 005194 AZ Primary

Addresses

Primary practice location

5555 W Thunderbird Rd
Glendale, AZ 85306-4622

Mailing address

2000 Spring Rd
Suite 200
Oak Brook, IL 60523-1804
Phone (630) 472-8800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090916000168 AZ Practitioner - Emergency Medicine 0941356927 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tec Emergency Physicians of Arizona, LLCGroup PAC ID 6204256084, 155 clinicians
East Valley Ep PLLCGroup PAC ID 4880081785, 15 clinicians

Practice addresses (Care Compare)

1064 E Ray Rd
Chandler, AZ 85225-1542
Phone (888) 732-3317

5656 S Power Rd
Gilbert, AZ 85295-8491
Phone (602) 830-4911

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
005194AZMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Emergency Physicians LLC Emergency Medicine CurrentSince Oct 2, 2023 Accepting new patients
East Valley Ep, PLLC CurrentSince Nov 9, 2022 Accepting new patients
Tec Emergency Physicians of Arizona, LLC CurrentSince Apr 23, 2021 Accepting new patients
Phoenix Physician Group, PLLC CurrentSince Dec 16, 2023 Accepting new patients
North Valley Emergency Specialists Emergency Medicine Past Accepting new patients
Arizona Post-Acute Medical Services 1 PC Past Accepting new patients
Emergency Physicians Professional Association LTD Emergency Medicine Past Accepting new patients
Emurgent Care PLLC Past Accepting new patients
Valley Emergency Physicians Inc Emergency Medicine Past Accepting new patients

Locations

3050 S Dobson Rd
Chandler, AZ 85248
Phone (480) 284-5867

1064 E Ray Rd
Chandler, AZ 85225
Phone (480) 494-5100

5656 S Power Rd
Gilbert, AZ 85295
Phone (480) 840-3733

1419 W Hunt Hwy
San Tan Vly, AZ 85143
Phone (480) 245-4300

5125 S Rural Rd
Tempe, AZ 85282
Phone (480) 306-8780

1500 S Mill Ave
Tempe, AZ 85281
Phone (480) 784-5500

Organizations & group practices 9

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

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1244505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1174759807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 SPRING RD",
            "address_2": "SUITE 200",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231804",
            "telephone_number": "630-472-8800",
            "fax_number": "630-472-9502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 W THUNDERBIRD RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064622",
            "telephone_number": "602-588-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "SHANTALL",
        "middle_name": "VIRIDIANA",
        "name_prefix": "Ms.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-09",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "005194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.