Organization Active NPI

James R. Hanna DPM PC

  • Podiatrist
  • Lockport, NY
National Provider Identifier
1104827609
Registry record updated Oct 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N005077 Issued in NY
Legal business name
JAMES R. HANNA DPM PC
Practice address
690 Davison Rd
Lockport, NY 14094-5338
Phone
(716) 433-8711
Fax
(716) 433-8705
NPI assigned
Aug 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2007

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

Authorized official

Name
James Robert Hanna, DPMNPI 1801898572
Title
President
Phone
(716) 433-8711

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
PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213E00000X N005077 NY Primary
Foot Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0131X

Addresses

Primary practice location

690 Davison Rd
Lockport, NY 14094-5338

Mailing address

690 Davison Rd
Lockport, NY 14094-5338
Phone (716) 433-8711

Other identifiers 1

IdentifierTypeStateIssuer
01578734MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040802001114 NY Part B Supplier - Clinic/Group Practice 2567433808 Receives reassigned benefits from 1 practitioner
Practice locations: Lockport, NY
O20100930024004 NY DME Supplier - Physician - Podiatry 2567433808 Practice locations: Lockport, NY

National Provider Directory

National Provider Directory

Locations

690 Davison Rd
Lockport, NY 14094
Phone (716) 433-8711

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1104827609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 DAVISON RD",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140945338",
            "telephone_number": "716-433-8711",
            "fax_number": "716-433-8705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 DAVISON RD",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140945338",
            "telephone_number": "716-433-8711",
            "fax_number": "716-433-8705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES R. HANNA DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "HANNA",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "716-433-8711",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N005077",
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01578734",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lockport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.