Individual provider Active NPI

Mary Etheldreda Hanna, M.D.

  • Anesthesiology Physician
  • Roanoke, VA
National Provider Identifier
1114967015
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
0101036083 Issued in VA
Practice address
202 Duke of Gloucester St SW
Roanoke, VA 24014-1372
Phone
(540) 345-4900
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X D44071 MD
Anesthesiology Physician 207L00000X 0101036083 VA Primary

Addresses

Primary practice location

202 Duke of Gloucester St SW
Roanoke, VA 24014-1372

Mailing address

8563 Harvest View CT
Ellicott City, MD 21043-6560
Phone (410) 750-0311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D44071MDMDAnesthesiology Physician
0101036083VAMDAnesthesiology Physician
D0044071MDMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harborview Anesthesia Associates-Allan M Birenberg M.D. P.a. Anesthesiology Past Accepting new patients
Surgical Anesthesia Associates, PLLC Anesthesiology Past Accepting new patients
Safe Sedation, PLLC Anesthesiology Past Accepting new patients
Coastal Healthcare Resources Inc Anesthesiology Past Accepting new patients
Providence Health Services, Inc Anesthesiology Past Accepting new patients
Anesthesia Network Services, LLC Anesthesiology Past Accepting new patients
North American Partners in Anesthesia Maryland LLC Anesthesiology PastSince Jul 10, 2022 Accepting new patients
First Colonies Anesthesia Associates, LLC Anesthesiology Past Accepting new patients
Inderjit Singh MD PC PastSince Jan 16, 2016 Accepting new patients

Organizations & group practices 9

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390348800000",
    "number": "1114967015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8563 HARVEST VIEW CT",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210436560",
            "telephone_number": "410-750-0311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 DUKE OF GLOUCESTER ST SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141372",
            "telephone_number": "540-345-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "MARY",
        "middle_name": "ETHELDREDA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2014-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MD",
            "license": "D44071",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101036083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.