Individual provider Active NPI

William Haehl, MD

  • Family Medicine Physician
  • Shelbyville, IN
National Provider Identifier
1477558484
Registry record updated Jan 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01026248A Issued in IN
Practice address
30 W Rampart St
Suite 210
Shelbyville, IN 46176-8877
Phone
(317) 398-0121
Fax
(317) 398-2335
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01026248A IN Primary

Addresses

Primary practice location

30 W Rampart St
Suite 210
Shelbyville, IN 46176-8877

Mailing address

1626 E St Rd 44
Suite a
Shelbyville, IN 46176-4057
Phone (317) 421-2012

Other identifiers 1

IdentifierTypeStateIssuer
100317720AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01026248AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Onsite Solutions Past Accepting new patients
Major Medical Group LLC Family Medicine Past Accepting new patients

Organizations & group practices 2

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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389657600000",
    "number": "1477558484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 E ST RD 44",
            "address_2": "SUITE A",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461764057",
            "telephone_number": "317-421-2012",
            "fax_number": "317-421-2016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W RAMPART ST",
            "address_2": "SUITE 210",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768877",
            "telephone_number": "317-398-0121",
            "fax_number": "317-398-2335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAEHL",
        "first_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2014-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01026248A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100317720A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.