Stetson Hanning, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2017036522 Issued in MO

Practice address

1001 Brittany Pkwy
Manchester, MO 63011-4325

Phone

(636) 330-7246

NPI assigned

Jul 7, 2021

Sex

Male

Sole proprietor

Yes

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.

• St Louis Advanced Physical Therapy Services LLC

  • Physical Therapist
  • Manchester, MO
  • NPI 1548852601
  NPD

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 7, 2021.

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1043881402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 COUNTY ROAD 5043",
            "city": "SALEM",
            "state": "MO",
            "postal_code": "655608167",
            "telephone_number": "573-247-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BRITTANY PKWY",
            "city": "MANCHESTER",
            "state": "MO",
            "postal_code": "630114325",
            "telephone_number": "636-330-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNING",
        "first_name": "STETSON",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-07",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2017036522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Haffner, MS,RD,LD,CDE
• Avery Hagedorn, PHARMD
• Thomas H Hale, MD
• Shannon Elizabeth Hamilton, PA
• Susan Irene Hanlon
• Cathleen Hardin, RN
• Stephen Edward Haring, O.D.
• Fizza Hassan, PA
• Heart 2 Heart Home Care LLC
• Denise Ella Henry, LCSW

• All providers in Manchester, MO
• Physical Therapy Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; 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.