Individual provider Active NPI

Richard Hanson, D.C.

  • Chiropractor
  • Jamestown, NY
National Provider Identifier
1154338606
Registry record updated Dec 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X005858 Issued in NY
Practice address
500 Pine St
Suite #2
Jamestown, NY 14701-5384
Phone
(716) 644-0445
Fax
(716) 644-0577
NPI assigned
Aug 1, 2006
Last updated
Dec 3, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X005858 NY Primary

Addresses

Primary practice location

500 Pine St
Suite #2
Jamestown, NY 14701-5384

Mailing address

500 Pine St
Suite #2
Jamestown, NY 14701-5384
Phone (716) 644-0445

Other identifiers 1

IdentifierTypeStateIssuer
02905622MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060926000257 NY Practitioner - Chiropractic 5890790885 Practice locations: Jamestown, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

500 Pine St
Jamestown, NY 14701-5384
Phone (716) 664-0445

500 Pine St Medical Arts BLDG
Jamestown, NY 14701-5384

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X005858NYMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259798400000",
    "number": "1154338606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 PINE ST",
            "address_2": "SUITE #2",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147015384",
            "telephone_number": "716-644-0445",
            "fax_number": "716-644-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 PINE ST",
            "address_2": "SUITE #2",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147015384",
            "telephone_number": "716-644-0445",
            "fax_number": "716-644-0577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2009-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X005858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02905622",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.