Elizabeth Pearl Haller

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

11093 Issued in SD

Practice address

1325 S Cliff Ave
Sioux Falls, SD 57105-1007

Phone

(605) 322-7905

NPI assigned

Apr 8, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Elizabeth Pearl Wanous Former name

Medicare fee-for-service enrollment

Enrolled in SD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Avera McKennan

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sioux Falls, SD
  • NPI 1699009944
  Medicare reassignment NPD
• Avera McKennan

  • Diagnostic Radiology Physician
  • Sioux Falls, SD
  • NPI 1053680678
  NPD
• Avera McKennan

  • Orthopaedic Surgery Physician
  • Sioux Falls, SD
  • NPI 1093262131
  NPD

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

{
    "created_epoch": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537142400000",
    "number": "1275929069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 N SAVANNAH DR",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571036615",
            "telephone_number": "605-321-6090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 S CLIFF AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051007",
            "telephone_number": "605-322-7905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLER",
        "first_name": "ELIZABETH",
        "middle_name": "PEARL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-08",
        "last_updated": "2018-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SD",
            "license": "243",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SD",
            "license": "11093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "WANOUS",
            "middle_name": "PEARL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kasandra Hall, LPC
• Tucker Hall
• Hallem Industries LLC.
• Ethan Allan Hallem
• Breanne Rose Haller, FNP-C
• Christine S. Halligan, MD
• Rian Halligan, RBT
• Sean C Halligan, MD
• Sydney Halling
• Alisha A Halver, PHARMD

• Internal Medicine Physician in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Internal Medicine Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.