Individual provider Active NPI

David H Hanson, MD

  • Family Medicine Physician
  • Mason City, IA
National Provider Identifier
1033220058
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21657 Issued in IA
Practice address
101 S Taylor Ave
Mason City, IA 50401-2849
Phone
(641) 422-7766
Fax
(641) 422-7788
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 21657 IA Primary

Addresses

Primary practice location

101 S Taylor Ave
Mason City, IA 50401-2849

Mailing address

621 S Illinois Ave
Suite 103
Mason City, IA 50401-5489
Phone (641) 494-3041

Other identifiers 2

IdentifierTypeStateIssuer
2030148MedicaidIA
11205OtherIAWELLMARK

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 Medicine

State licenses

LicenseStateTypeSpecialty
21657IAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033220058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S ILLINOIS AVE",
            "address_2": "SUITE 103",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504015489",
            "telephone_number": "641-494-3041",
            "fax_number": "641-494-3059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S TAYLOR AVE",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504012849",
            "telephone_number": "641-422-7766",
            "fax_number": "641-422-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "DAVID",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "21657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2030148",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "11205",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.