Individual provider Active NPI

Terry Wayne Hansen, M.D.

  • Specialist
  • Social Circle, GA
National Provider Identifier
1013906387
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
047330 Issued in GA
Practice address
1027 Bateman Dr
Suite B
Social Circle, GA 30025-5025
Phone
(770) 464-2048
Fax
(770) 464-9995
NPI assigned
Oct 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 047330 GA Primary

Addresses

Primary practice location

1027 Bateman Dr
Suite B
Social Circle, GA 30025-5025

Mailing address

703 Sterling Water CT
Monroe, GA 30655-7707
Phone (770) 266-7954

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20041110000743 GA Practitioner - Family Practice 3072576057 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
047330GAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Premise Health of Georgia Medical, P.C. Current Accepting new patients
Premise Health of Georgia Medical PC CurrentSince Apr 13, 2014 Accepting new patients
Premise Health of Georgia Medical PC CurrentSince Apr 13, 2014 Accepting new patients
Monroe Hma Physician Management LLC PastSince Jan 13, 2014 Accepting new patients

Locations

184 Professional Dr
Unit B
Baldwin, GA 30511
Phone (706) 894-2714

16906 Collection Ctr Dr
Chicago, IL 60693

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": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1013906387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 STERLING WATER CT",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306557707",
            "telephone_number": "770-266-7954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 BATEMAN DR",
            "address_2": "SUITE B",
            "city": "SOCIAL CIRCLE",
            "state": "GA",
            "postal_code": "300255025",
            "telephone_number": "770-464-2048",
            "fax_number": "770-464-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "TERRY",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "047330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Social Circle, GA

Sources for this page

Verify at the official NPI Registry.