NPIMap

Individual provider Active NPI

Charles Justin Hall, DO

  • Emergency Medicine Physician
  • Omaha, NE
National Provider Identifier
1811302284
Registry record updated Jun 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
7293 Issued in NE
Practice address
981150 Nebraska Medical Ctr
Omaha, NE 68198-1150
Phone
(402) 559-6802
NPI assigned
Jun 24, 2014
Last updated
Jun 24, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2014

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 7293 NE Primary

Addresses

Primary practice location

981150 Nebraska Medical Ctr
Omaha, NE 68198-1150

Mailing address

12424 Binney St
Omaha, NE 68164-4210
Phone (909) 731-0195

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170605001092 CA Practitioner - Emergency Medicine 8224257332 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
College of Osteo Med of the Pacific at Pomona, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ventura Emergency PhysiciansGroup PAC ID 7618012063, 14 clinicians
Community Memorial Health SystemGroup PAC ID 9537155676, 187 clinicians

Practice addresses (Care Compare)

147 N Brent St
Ventura, CA 93003-2809
Phone (805) 652-5051

2721 E Main St
Ventura, CA 93003-2803
Phone (805) 667-2841

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7293NEMDEmergency Medicine Physician
1494NEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Memorial Health System CurrentSince Jan 1, 2022 Accepting new patients
Community Memorial Health System Current Accepting new patients
Ojai Emergency Physicians Corporation Emergency Medicine CurrentSince Jun 15, 2017 Accepting new patients
Ventura Emergency Physicians Emergency Medicine CurrentSince Jun 25, 2017 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Community Memorial Health System CurrentSince Jan 1, 2022 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Jul 1, 2017 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Jul 1, 2017 Accepting new patients
Unmc Past Accepting new patients

Locations

2309 Antonio Ave
Camarillo, CA 93010
Phone (805) 389-5655

422 Arneill Rd
Ste B
Camarillo, CA 93010
Phone (805) 383-4510

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

24451 Health Center Dr
Laguna Hills, CA 92653
Phone (949) 452-3573

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1306 Maricopa Hwy
Ojai, CA 93023
Phone (805) 569-7367

1600 N Rose Ave
Oxnard, CA 93030
Phone (805) 988-2500

2921 Saviers Rd
Oxnard, CA 93033
Phone (805) 487-5588

138 W Main St
Ste E
Ventura, CA 93001
Phone (805) 667-2850

147 N Brent St
Ventura, CA 93003
Phone (805) 652-5011

2721 E Main St
Ventura, CA 93003
Phone (805) 656-6272

5855 Olivas Park Dr
Ventura, CA 93003
Phone (805) 652-5469

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403568000000",
    "number": "1811302284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12424 BINNEY ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681644210",
            "telephone_number": "909-731-0195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "981150 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681981150",
            "telephone_number": "402-559-6802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "CHARLES",
        "middle_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-24",
        "last_updated": "2014-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NE",
            "license": "7293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.