NPIMap

Organization Active NPI

Pediatric Hematology Clinic LTD

  • Pediatric Hematology & Oncology Physician
  • Sioux Falls, SD
National Provider Identifier
1003956343
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
1562 Issued in SD
Legal business name
PEDIATRIC HEMATOLOGY CLINIC LTD
Practice address
1000 E 21St St
Suite 3100
Sioux Falls, SD 57105-1035
Phone
(605) 322-7595
Fax
(605) 322-7599
NPI assigned
Feb 7, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Marwan Daoud Hanna, M.D.
Title
President
Phone
(605) 322-7595

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hematology & Oncology Physician 2080P0207X 1562 SD Primary

Addresses

Primary practice location

1000 E 21St St
Suite 3100
Sioux Falls, SD 57105-1035

Mailing address

1000 E 21St St
Suite 3100
Sioux Falls, SD 57105-1035
Phone (605) 322-7595

Other identifiers 2

IdentifierTypeStateIssuer
4997079OtherSDBCBS OF SD GROUP NUMBER
3008526OtherSDMEDICA GROUP NUMBER

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003956343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E 21ST ST",
            "address_2": "SUITE 3100",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051035",
            "telephone_number": "605-322-7595",
            "fax_number": "605-322-7599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E 21ST ST",
            "address_2": "SUITE 3100",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051035",
            "telephone_number": "605-322-7595",
            "fax_number": "605-322-7599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC HEMATOLOGY CLINIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HANNA",
        "authorized_official_first_name": "MARWAN",
        "authorized_official_middle_name": "DAOUD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "605-322-7595",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "SD",
            "license": "1562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF SD GROUP NUMBER",
            "identifier": "4997079",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA GROUP NUMBER",
            "identifier": "3008526",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.