Mary A Haller, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

515 Issued in NE

Practice address

1401 E H St
MC Cook, NE 69001-3589

Phone

(308) 344-4110

Fax

(308) 344-8369

NPI assigned

Jul 27, 2006

Last updated

Aug 30, 2013By the provider in NPPES

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

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: maryhaller@mccpc.allscriptsdirect.net

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.

• Community Hospital Association

  dba Community Hospital Professional Services

  • Emergency Medicine Physician
  • McCook, NE
  • NPI 1588771158

  Physician Assistant

  Medicare reassignment NPD

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377820800000",
    "number": "1396769857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 E H ST",
            "city": "MC COOK",
            "state": "NE",
            "postal_code": "690013589",
            "telephone_number": "308-344-4110",
            "fax_number": "308-344-8369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 E H ST",
            "city": "MC COOK",
            "state": "NE",
            "postal_code": "690013589",
            "telephone_number": "308-344-4110",
            "fax_number": "308-344-8369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLER",
        "first_name": "MARY",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2013-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "02300010101",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10210",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dirk M Gray, OD
• Sandra Gray, LMPHP
• Destiny Guess
• Kaitlin Haag, D.D.S.
• Holly Hagan
• Courtney Hampton
• Kristyl Ann Hanchera
• Ryan Hardin, PT, DPT. ATC
• Brianna Lynn Haskins, RDH
• Maria C Heapy, PHARM D

• Medical Physician Assistant in McCook, NE
• Providers in McCook, NE by specialty
• Medical Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2013; 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.