Kathleen Anne Hannifan, M.D

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

8131A Issued in WY

Practice address

1200 E Elizabeth St
The Youth Clinic
Fort Collins, CO 80524-4007

Phone

(979) 267-9510

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kathleenhannifan@yc.allscriptsdirect.net

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.

• Fort Collins Youth Clinic

  • Pediatrics Physician
  • Fort Collins, CO
  • NPI 1336292622
  NPD
• Poudre Valley Health Care Inc.

  • General Acute Care Hospital
  • Fort Collins, CO
  • NPI 1760492714
  NPD (past)
• Laramie Physicians for Women PC

  • Obstetrics & Gynecology Physician
  • Laramie, WY
  • NPI 1528162070

  Adolescent Medicine

  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405468800000",
    "number": "1114037389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E ELIZABETH ST",
            "address_2": "THE YOUTH CLINIC",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244007",
            "telephone_number": "970-267-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E ELIZABETH ST",
            "address_2": "THE YOUTH CLINIC",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244007",
            "telephone_number": "979-267-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNIFAN",
        "first_name": "KATHLEEN",
        "middle_name": "ANNE",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2014-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "ML20008677",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "WY",
            "license": "8131A",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WY",
            "license": "8131A",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "0051721",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Hankins
• Hanlon-Bush Investments, LLC
• Janice Hanlon-Toth, M.D.
• Hannah Lani, LLC
• Hannah Saunders Therapy, LLC
• Marshall Hannum, OTR
• Emily Hansen
• Esther Grace Hansen, RD
• Kate Hansen
• Kristin J. Hansen, PA-C

• Pediatrics Physician in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Pediatrics Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.