Active NPI
Lesley Ann Hanson, D.O.
- Critical Care Medicine (Internal Medicine) Physician
- Saint Louis, MO
National Provider Identifier
1013909589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine (Internal Medicine) Physician
- License
- R2C19
- Practice address
- 11133 Dunn Rd
Saint Louis, MO 63136-6119 - Phone
- (314) 317-0600
- Fax
- (314) 317-0606
- NPI assigned
- Aug 19, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | R2C19 | MO | Primary |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 036-054233 | IL |
Addresses
Primary practice location
11133 Dunn Rd
Saint Louis, MO 63136-6119
Mailing address
12101 Woodcrest Executive Dr
Suite 210
Saint Louis, MO 63141-5047
Phone (314) 317-0600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013909589 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-054233 | IL | MD | Critical Care Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christian Hospital Northeast- Northwest | Past | Accepting new patients |
Interoperability endpoints
- https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Organizations & group practices 1
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.
-
- General Practice Physician
- Saint Louis, MO
- NPI 1265440150
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425945600000",
"number": "1013909589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12101 WOODCREST EXECUTIVE DR",
"address_2": "SUITE 210",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631415047",
"telephone_number": "314-317-0600",
"fax_number": "314-317-0606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11133 DUNN RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631366119",
"telephone_number": "314-317-0600",
"fax_number": "314-317-0606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSON",
"first_name": "LESLEY",
"middle_name": "ANN",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-19",
"last_updated": "2015-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "MO",
"license": "R2C19",
"primary": true
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "IL",
"license": "036-054233",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1013909589",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.