Organization Active NPI

Charles D Hanshaw DO Inc

  • Internal Medicine Physician
  • Dayton, OH
National Provider Identifier
1063692341
Registry record updated Jun 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34003234H Issued in OH
Legal business name
CHARLES D HANSHAW DO INC
Practice address
8940 Kingsridge Dr
Suite 103
Dayton, OH 45458-1632
Phone
(937) 439-7430
Fax
(937) 439-7446
NPI assigned
Nov 5, 2007
Last updated
Jun 30, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2009

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

Authorized official

Name
Charles D Hanshaw, DONPI 1871523209
Title
President
Phone
(937) 439-7430

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 009141 OH
Internal Medicine Physician 207R00000X 34003234H OH Primary

Addresses

Primary practice location

8940 Kingsridge Dr
Suite 103
Dayton, OH 45458-1632

Mailing address

8940 Kingsridge Dr
Suite 103
Dayton, OH 45458-1632
Phone (937) 439-7430

Other identifiers 1

IdentifierTypeStateIssuer
0734245MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050915000195 OH Part B Supplier - Clinic/Group Practice 5991738494 Receives reassigned benefits from 3 practitioners
Practice locations: Dayton, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D0350214C D Hanshaw DO Inc8940 Kingsridge Dr Ste 103, Dayton, OH 45458Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8833/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246320000000",
    "number": "1063692341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8940 KINGSRIDGE DR",
            "address_2": "SUITE 103",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454581632",
            "telephone_number": "937-439-7430",
            "fax_number": "937-439-7446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8940 KINGSRIDGE DR",
            "address_2": "SUITE 103",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454581632",
            "telephone_number": "937-439-7430",
            "fax_number": "937-439-7446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES D HANSHAW DO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-05",
        "last_updated": "2009-06-30",
        "status": "A",
        "authorized_official_last_name": "HANSHAW",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-439-7430",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "009141",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34003234H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0734245",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; 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.