NPIMap

Individual provider Active NPI

Gregory Hannabas, M.D.

  • Family Medicine Physician
  • Elma, WA
National Provider Identifier
1053792200
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD.MD.61537270 Issued in WA
Practice address
600 E Main St
Elma, WA 98541-9560
Phone
(360) 346-2222
NPI assigned
Jun 13, 2015
Last updated
May 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD.MD.61537270 WA Primary
Family Medicine Physician 207Q00000X S9307 TX

Addresses

Primary practice location

600 E Main St
Elma, WA 98541-9560

Mailing address

600 E Main St
Elma, WA 98541-9560
Phone (360) 346-2222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210819002956 TX Practitioner - Family Practice 6204231814 Reassigns benefits to 2 organizations
I20240530003401 WA Practitioner - Family Practice 6204231814 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas Tech University Health Science Center School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

579 E Main St
Elma, WA 98541-9551
Phone (360) 346-2222

600 E Main St
Elma, WA 98541-9560
Phone (360) 346-2222

610 E Main St
Elma, WA 98541-9353
Phone (360) 346-2222

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.MD.61537270WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grays Harbor County Public Hospital District No 1 CurrentSince Jun 1, 2024 Accepting new patients
Lynn County Hospital District CurrentSince Aug 9, 2021 Accepting new patients
Grays Harbor County Public Hospital District No 1 Single Specialty CurrentSince Jun 1, 2024 Accepting new patients
Concord Medical Group of Texas PLLC Single Specialty CurrentSince Jun 30, 2021 Accepting new patients
Lynn County Hospital District Single Specialty CurrentSince Aug 9, 2021 Accepting new patients

Locations

200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241

2200 N Bryan Ave
Lamesa, TX 79331
Phone (806) 872-2183

1104 N Avenue S
Post, TX 79356
Phone (806) 495-2853

2600 Lockwood St
Tahoka, TX 79373
Phone (806) 998-4533

579 E Main St
Elma, WA 98541
Phone (360) 346-2222

600 E Main St
Elma, WA 98541
Phone (360) 346-2222

610 E Main St
Elma, WA 98541
Phone (360) 346-2222

105 W Simpson Ave
McCleary, WA 98557
Phone (360) 346-2222

Organizations & group practices 5

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1434153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1053792200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E MAIN ST",
            "city": "ELMA",
            "state": "WA",
            "postal_code": "985419560",
            "telephone_number": "360-346-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E MAIN ST",
            "city": "ELMA",
            "state": "WA",
            "postal_code": "985419560",
            "telephone_number": "360-346-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNABAS",
        "first_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-13",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD.MD.61537270",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S9307",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elma, WA

Sources for this page

Verify at the official NPI Registry.