Active NPI
Theresa A Hanes, CRNP
- Nurse Practitioner
- Huntsville, AL
National Provider Identifier
1164464384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 1049736
- Practice address
- 600 Saint Clair Ave SW
BLDG 6 Suite 14
Huntsville, AL 35801-5008 - Phone
- (256) 536-4700
- Fax
- (256) 536-4117
- NPI assigned
- Jun 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 1049736 | AL | Primary |
Addresses
Primary practice location
600 Saint Clair Ave SW
BLDG 6 Suite 14
Huntsville, AL 35801-5008
Mailing address
600 Saint Clair Ave SW
BLDG 6 Suite 14
Huntsville, AL 35801-5008
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 515-45706 | Other | AL | BCBS OF ALABAMA |
| 051528320 | Other | AL | BLUE CROSS BLUE SHIELD AL |
| 510-50070 | Other | AL | BCBS OF ALABAMA |
| P00214863 | Other | AL | RR MEDICARE |
| CA0084 | Other | AL | RR MEDICARE |
| 515-94366 | Other | AL | BCBS OF ALABAMA |
| 51111375 | Other | AL | BCBS OF ALABAMA |
| 515-45707 | Other | AL | BCBS OF ALABAMA |
| 515-45708 | Other | AL | BCBS OF ALABAMA |
| 515-45764 | Other | AL | BCBS OF ALABAMA |
| 528701110 | Medicaid | AL |
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1049736 | AL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300924800000",
"number": "1164464384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 SAINT CLAIR AVE SW",
"address_2": "BLDG 6 SUITE 14",
"city": "HUNTSVILLE",
"state": "AL",
"postal_code": "358015008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 SAINT CLAIR AVE SW",
"address_2": "BLDG 6 SUITE 14",
"city": "HUNTSVILLE",
"state": "AL",
"postal_code": "358015008",
"telephone_number": "256-536-4700",
"fax_number": "256-536-4117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANES",
"first_name": "THERESA",
"middle_name": "A",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-12",
"last_updated": "2011-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "AL",
"license": "1049736",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF ALABAMA",
"identifier": "515-45706",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD AL",
"identifier": "051528320",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF ALABAMA",
"identifier": "510-50070",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00214863",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "CA0084",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF ALABAMA",
"identifier": "515-94366",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF ALABAMA",
"identifier": "51111375",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF ALABAMA",
"identifier": "515-45707",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF ALABAMA",
"identifier": "515-45708",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF ALABAMA",
"identifier": "515-45764",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "528701110",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Huntsville, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.