Individual provider Active NPI

William Martin Elliott II, MD

  • Emergency Medicine Physician
  • Bluefield, WV
National Provider Identifier
1730133588
Registry record updated Jun 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
13508 Issued in WV
Practice address
500 Cherry St
Bluefield, WV 24701-3306
Phone
(304) 327-1100
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2013

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 13508 WV Primary

Addresses

Primary practice location

500 Cherry St
Bluefield, WV 24701-3306

Mailing address

4750 Hempstead Station Dr
Kettering, OH 45429-5164
Phone (800) 875-0136

Other identifiers 7

IdentifierTypeStateIssuer
000143660OtherWVBLUE CROSS BLUE SHIELD
P00309253OtherRR MEDICARE BLUEFIELD
1003314OtherWVBRICKSTREET
3001609OtherWVBRICKSTREET
001827970OtherWVBLUE CROSS BLUE SHIELD
0056780000MedicaidWV
010283205MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20050316000756 WV Practitioner - Emergency MedicinePractitioner - Family Practice 2264487859 Reassigns benefits to 5 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Racine Observation Medical Group, PLLC Emergency Medicine CurrentSince Jun 24, 2017 Accepting new patients
West Virginia Emergency Physicians, LLP Emergency Medicine CurrentSince Sep 2, 2017 Accepting new patients
Health Care Alliance, Inc. Emergency Medicine CurrentSince Apr 1, 2020 Accepting new patients
Allied West Virginia Emergency Physicians PLLC Emergency Medicine CurrentSince Aug 1, 2016 Accepting new patients
Greenbrier Emergency Services, Inc. Emergency Medicine CurrentSince Nov 15, 2014 Accepting new patients
Bluefield Regional Medical Center Inc Past Accepting new patients
Epmg of Virginia P C Past Accepting new patients
Virginia Em-I Medical Services, PC Emergency Medicine Past Accepting new patients
Bluefield Regional Medical Center Past Accepting new patients

Locations

1408 Campbell Dr
Ironton, OH 45638
Phone (740) 533-9710

500 Cherry St
Bluefield, WV 24701
Phone (304) 324-2614

3200 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-2550

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

2900 1st Ave
Huntington, WV 25702
Phone (304) 526-1111

1400 Hospital Dr
Hurricane, WV 25526
Phone (304) 757-1700

20 Hospital Dr
Logan, WV 25601
Phone (304) 792-1101

1200 J D Anderson Dr
Morgantown, WV 26505
Phone (304) 598-1460

601 Colliers Way
Weirton, WV 26062
Phone (304) 364-5156

230 Hospital Plz
Weston, WV 26452
Phone (304) 269-8000

Interoperability endpoints

  • Direct secure messaging: elliottw@yourcarecommunity.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371600000000",
    "number": "1730133588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 HEMPSTEAD STATION DR",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454295164",
            "telephone_number": "800-875-0136",
            "fax_number": "937-619-4150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CHERRY ST",
            "city": "BLUEFIELD",
            "state": "WV",
            "postal_code": "247013306",
            "telephone_number": "304-327-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "WILLIAM",
        "middle_name": "MARTIN",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2013-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "13508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000143660",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE BLUEFIELD",
            "identifier": "P00309253",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRICKSTREET",
            "identifier": "1003314",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRICKSTREET",
            "identifier": "3001609",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "001827970",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0056780000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010283205",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluefield, WV

Sources for this page

Verify at the official NPI Registry.