Active NPI
Kristen Marie Hanko, M.D.
- Pediatrics Physician
- Irmo, SC
National Provider Identifier
1053760173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD39431
- Practice address
- 1033 Kinley Rd
Irmo, SC 29063-9635 - Phone
- (803) 376-2838
- Fax
- (803) 781-7977
- NPI assigned
- Jun 9, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD39431 | SC | Primary |
Addresses
Primary practice location
1033 Kinley Rd
Irmo, SC 29063-9635
Mailing address
2113 Adams GRV Ste 101
Columbia, SC 29203-6957
Phone (803) 256-0531
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 394317 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170220001155 | SC | Order and Referring Only - Pediatric Medicine | 4981987823 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD39431 | SC | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolina Pediatrics & Adolescent Care, PA | Pediatrics | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pediatrics Physician
- Columbia, SC
- NPI 1306805056
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654560000000",
"number": "1053760173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2113 ADAMS GRV STE 101",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292036957",
"telephone_number": "803-256-0531",
"fax_number": "803-765-9052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1033 KINLEY RD",
"city": "IRMO",
"state": "SC",
"postal_code": "290639635",
"telephone_number": "803-376-2838",
"fax_number": "803-781-7977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANKO",
"first_name": "KRISTEN",
"middle_name": "MARIE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-09",
"last_updated": "2022-06-07",
"certification_date": "2022-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "SC",
"license": "MD39431",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "394317",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Irmo, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.