Individual provider Active NPI

William Joseph Hammond, MD, MSC

  • Pediatric Surgery Physician
  • Idaho Falls, ID
National Provider Identifier
1346582137
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
9361477 Issued in ID
Practice address
3200 Channing Way Ste 303
Idaho Falls, ID 83404-7546
Phone
(208) 535-4515
Fax
(208) 535-4565
NPI assigned
Mar 20, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X 9361477 ID Primary

Addresses

Primary practice location

3200 Channing Way Ste 303
Idaho Falls, ID 83404-7546

Mailing address

PO Box 277381
Atlanta, GA 30384-4072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20241009004312 ID Practitioner - General Surgery 8123550514 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9361477IDMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Idaho Physician Services Inc. CurrentSince Oct 7, 2024 Accepting new patients
Ny Presbyterian Hospital - Cornell Past Accepting new patients
Eirmc Hospitalist Services LLC PastSince Oct 6, 2024 Accepting new patients

Locations

3200 Channing Way
Ste A205
Idaho Falls, ID 83404
Phone (208) 535-4580

3200 Channing Way
Ste 303
Idaho Falls, ID 83404
Phone (208) 535-4400

3200 Channing Way
Ste 205
Idaho Falls, ID 83404
Phone (208) 535-4300

2860 Channing Way
Ste 116
Idaho Falls, ID 83404
Phone (208) 529-0575

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: william.hammond@hca3.eclinicaldirectplus.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1363737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1346582137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277381",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303844072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 CHANNING WAY STE 303",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047546",
            "telephone_number": "208-535-4515",
            "fax_number": "208-535-4565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMOND",
        "first_name": "WILLIAM",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD, MSC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-20",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "ID",
            "license": "9361477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.