Individual provider Active NPI

Ingrid Marie Hanna, MSPT

  • Physical Therapist
  • Avon, CT
National Provider Identifier
1174634141
Registry record updated Aug 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
014158 Issued in CT
Practice address
34 Dale Rd
Avon, CT 06001-3659
Phone
(860) 678-8655
Fax
(860) 678-7335
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305215199 VA
Physical Therapist 225100000X 1145688 TX
Physical Therapist 225100000X 014158 CT Primary

Addresses

Primary practice location

34 Dale Rd
Avon, CT 06001-3659

Mailing address

34 Dale Rd
Avon, CT 06001-3659
Phone (860) 678-8655

Other names 1

  • Hanna Physical Therapy, PLLC Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221014002247 VA Practitioner - Physical Therapist in Private Practice 0941207450 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
014158CTMDPhysical Therapist
1145688TXMDPhysical Therapist
2305215199VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Associates of Central Virginia Limited Partnership Physical Therapist CurrentSince Sep 6, 2022 Accepting new patients
Rehabilitation Associates of Central Virginia Limited Partnership Physical Therapist CurrentSince Sep 6, 2022 Accepting new patients
Hanna Physical Therapy PLLC Physical Therapist PastSince Oct 16, 2015 Accepting new patients

Locations

1111 Corporate Park Dr
Ste B
Forest, VA 24551
Phone (434) 525-4851

20347 Timberlake Rd
Ste B
Lynchburg, VA 24502
Phone (434) 237-6812

Organizations & group practices 3

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722643200000",
    "number": "1174634141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 DALE RD",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013659",
            "telephone_number": "860-678-8655",
            "fax_number": "860-678-7335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 DALE RD",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013659",
            "telephone_number": "860-678-8655",
            "fax_number": "860-678-7335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "INGRID",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2024-08-03",
        "certification_date": "2024-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305215199",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1145688",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "014158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HANNA",
            "last_name": "THERAPY, PLLC",
            "middle_name": "PHYSICAL",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Avon, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2024; 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.