Individual provider Active NPI

Jason Hansel, PHARMD

  • Pharmacist
  • Davenport, IA
National Provider Identifier
1053696153
Registry record updated Aug 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
19323 Issued in IA
Practice address
4436 N Brady St Ste 101
Davenport, IA 52806-4063
Phone
(563) 386-2909
NPI assigned
Oct 20, 2011
Last updated
Aug 8, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 19323 IA Primary
Pharmacist 183500000X 051288109 IL

Addresses

Primary practice location

4436 N Brady St Ste 101
Davenport, IA 52806-4063

Mailing address

4436 N Brady St Ste 101
Davenport, IA 52806-4063
Phone (563) 386-2909

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)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
19323IAMDPharmacist
051288109ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375920000000",
    "number": "1053696153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4436 N BRADY ST STE 101",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528064063",
            "telephone_number": "563-386-2909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4436 N BRADY ST STE 101",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528064063",
            "telephone_number": "563-386-2909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEL",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-20",
        "last_updated": "2013-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "19323",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051288109",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; 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.