Hallie R Theobald, PA
Individual provider Active NPI Physician Assistant · Smith Center, KS
NPI 1992384002 · NPPES record last updated Dec 4, 2024
Key facts
- NPI
- 1992384002
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 15-02462 (KS)
- Practice address
- 921 E Highway 36
Smith Center, KS 66967-9582 - Phone
- (785) 282-6845
- Fax
- (785) 282-6331
- NPI assigned
- Apr 6, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Great Plains of Smith Co Inc
Practice addresses (Care Compare)
614 S Main
Smith Center, KS 66967
PO Box
Suite 349
Smith Center, KS 66967
Hospital & facility affiliations
- Smith County Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210602003060 | KS | Practitioner - Physician Assistant | 6103225628 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15-02462 | KS | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Great Plains of Smith Co., Inc. | Current |
Accepting new patients | |
| Great Plains of Smith Co., Inc. | Current |
Accepting new patients | |
| Theoria Medical | Physician Assistant | Current |
Accepting new patients |
| Great Plains of Smith Co Inc | Past | Accepting new patients |
Locations
605 E Melvin St
Arma, KS 66712
Phone (620) 347-4103
921 E Highway 36
Smith Center, KS 66967
Phone (785) 282-6834
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Physician Assistant | 363A00000X | 15-02462 | KS | Yes |
Addresses
Primary practice location
921 E Highway 36
Smith Center, KS 66967-9582
Mailing address
PO Box 349
Smith Center, KS 66967-0349
Phone (785) 282-6845
Other names
- Hallie R McCall
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | julie.haresnape@scmhks.org |
Other providers in Smith Center, KS
- Smith Center Dental Clinic
- Smith Center Operator, LLC
- Smith County Courthouse
- Smith County Courthouse
- Sunporch of Smith Center Inc
- Ronald Lynn Tompkins
- Unified School District 237
- Steven Weltmer
- Leah Elizabeth Wiehl
- Tamara J. Windscheffel
All providers in Smith Center, KS · Physician Assistant in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.