Individual provider Active NPI

Abigail Halleron

  • Emergency Medicine Physician
  • Shelbyville, KY
National Provider Identifier
1912430612
Registry record updated Mar 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
55604 Issued in KY
Practice address
727 Hospital Dr
Shelbyville, KY 40065-1660
Phone
(502) 647-4170
NPI assigned
Apr 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2020032474 MO
Student in an Organized Health Care Education/Training Program 390200000X KY
Emergency Medicine Physician 207P00000X 55604 KY Primary

Addresses

Primary practice location

727 Hospital Dr
Shelbyville, KY 40065-1660

Mailing address

727 Hospital Dr
Shelbyville, KY 40065-1660
Phone (502) 647-4170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, AL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210913002299 KY Practitioner - Emergency Medicine 0446506943 Reassigns benefits to 1 organization
I20240422000206 AL Practitioner - Emergency Medicine 0446506943 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2020032474MOMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Relias Emergency Medicine Specialists of Regional, LLC Emergency Medicine CurrentSince Nov 24, 2024 Accepting new patients
Paragon Contracting Services LLC Emergency Medicine CurrentSince May 1, 2024 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Aug 1, 2021 Accepting new patients
Relias Emergency Medicine Specialists of Northport, LLC Emergency Medicine CurrentSince Nov 1, 2024 Accepting new patients

Locations

810 Saint Vincents Dr
Birmingham, AL 35205
Phone (205) 930-2456

2700 Hospital Dr
Northport, AL 35476
Phone (205) 333-4500

6670 Green Dr
Trussville, AL 35173
Phone (205) 537-3337

809 University Blvd E
Tuscaloosa, AL 35401
Phone (205) 333-4661

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

727 Hospital Dr
Shelbyville, KY 40065
Phone (502) 633-2345

Organizations & group practices 4

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": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679097600000",
    "number": "1912430612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 HOSPITAL DR",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400651660",
            "telephone_number": "502-647-4170",
            "fax_number": "502-633-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 HOSPITAL DR",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400651660",
            "telephone_number": "502-647-4170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLERON",
        "first_name": "ABIGAIL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-10",
        "last_updated": "2023-03-18",
        "certification_date": "2023-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2020032474",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "55604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, KY

Sources for this page

Verify at the official NPI Registry.