NPIMap

Individual provider Active NPI

Wesley Robert Hanson, MD

  • Family Medicine Physician
  • Roan Mountain, TN
National Provider Identifier
1104821743
Registry record updated Jan 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
14319 Issued in TN
Practice address
152 Highway 143
Roan Mountain, TN 37687-3002
Phone
(423) 772-3276
Fax
(423) 772-4816
NPI assigned
Jun 20, 2005
Sex
Male
Sole proprietor
No

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 2

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

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Wisconsin, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rural Health Services Consortium of Upper East Tennessee Inc 50 clinicians

Practice addresses (Care Compare)

4307 Hwy 68 S
Rogersville, TN 37857-3155
Phone (423) 921-1300

PO Box
Suite 850
Rogersville, TN 37857

Hospital & facility affiliations

  • Amedisys Home Health Care Home health agency, Elizabethton, TN, CCN 447505
  • Sycamore Shoals Hospital Hospital, Elizabethton, TN, CCN 440018

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081218000690 TN Practitioner - Family Practice 6305908724 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Health Services Consortium of Upper East Tennessee Inc Current Accepting new patients
Rural Health Services Consortium of Upper East Tennessee Inc CurrentSince Oct 1, 1987 Accepting new patients
Rural Health Services Consortium of Upper East Tennessee Inc CurrentSince Oct 1, 1987 Accepting new patients
Rural Health Services Consortium of Upper East Tennessee Inc Past Accepting new patients

Locations

222 Oak St
Mountain City, TN 37683
Phone (423) 727-6319

152 Highway 143
Roan Mountain, TN 37687
Phone (423) 282-3377

4966 Highway 11W
Rogersville, TN 37857
Phone (423) 272-5600

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 14319 TN Primary

Addresses

NPPES NPI Registry

Primary practice location

152 Highway 143
Roan Mountain, TN 37687-3002

Mailing address

PO Box 850
Rogersville, TN 37857-0850
Phone (423) 772-3276

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
2007143OtherTNBCBST
3198461MedicaidTN

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 29, 2010.

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264723200000",
    "number": "1104821743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850",
            "city": "ROGERSVILLE",
            "state": "TN",
            "postal_code": "378570850",
            "telephone_number": "423-772-3276",
            "fax_number": "423-772-4816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 HIGHWAY 143",
            "city": "ROAN MOUNTAIN",
            "state": "TN",
            "postal_code": "376873002",
            "telephone_number": "423-772-3276",
            "fax_number": "423-772-4816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "WESLEY",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2010-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "14319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST",
            "identifier": "2007143",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3198461",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roan Mountain, TN

Sources for this page

Verify at the official NPI Registry.