Individual provider Active NPI

Brian Thomas Hansen, DC

  • Chiropractor
  • Council Bluffs, IA
National Provider Identifier
1063078871
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
095690 Issued in IA
Practice address
1920 Rue St Ste 11
Council Bluffs, IA 51503-3601
Phone
(712) 323-6824
NPI assigned
May 16, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 095690 IA Primary

Addresses

Primary practice location

1920 Rue St Ste 11
Council Bluffs, IA 51503-3601

Mailing address

1920 Rue St Ste 11
Council Bluffs, IA 51503-3601
Phone (712) 323-6824

Other identifiers 1

IdentifierTypeStateIssuer
1164875092MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190627000199 IA Practitioner - Chiropractic 3274867197 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1920 Rue St
Suite 11
Council Bluffs, IA 51503-3601
Phone (712) 323-6824

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
095690IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Kite Family Chiropractic PLC CurrentSince May 23, 2019 Accepting new patients
Hansen Chiropractic PLC CurrentSince Jan 1, 2023 Accepting new patients

Locations

18 W 6th St
Atlantic, IA 50022
Phone (712) 243-7737

1920 Rue St
Ste 11
Council Bluffs, IA 51503
Phone (712) 323-6824

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1557964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1063078871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 RUE ST STE 11",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515033601",
            "telephone_number": "712-323-6824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 RUE ST STE 11",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515033601",
            "telephone_number": "712-323-6824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "BRIAN",
        "middle_name": "THOMAS",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-16",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "095690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164875092",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.