Organization Active NPI

Hanke Optometry

  • Optometrist
  • Middletown, OH
National Provider Identifier
1205453008
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
HANKE OPTOMETRY
Practice address
Hanke Optometry
2900 Towne Blvd
Middletown, OH 45044-6200
Phone
(513) 423-5869
Fax
(513) 423-6398
NPI assigned
Jun 29, 2020
Last updated
Sep 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Authorized official

Name
Kelsey E Hanke, ODNPI 1124510326
Title
Provider and Owner of Business
Phone
(937) 573-8969

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

Hanke Optometry
2900 Towne Blvd
Middletown, OH 45044-6200

Mailing address

329 E 1St St Apt 219
Dayton, OH 45402-1554
Phone (937) 573-8969

Other identifiers 1

IdentifierTypeStateIssuer
0416206MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200824000924 OH Part B Supplier - Clinic/Group Practice 1557787447 Receives reassigned benefits from 1 practitioner
Practice locations: Middletown, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1593388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662595200000",
    "number": "1205453008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 E 1ST ST APT 219",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454021554",
            "telephone_number": "937-573-8969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HANKE OPTOMETRY",
            "address_2": "2900 TOWNE BLVD",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450446200",
            "telephone_number": "513-423-5869",
            "fax_number": "513-423-6398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANKE OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-29",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A",
        "authorized_official_last_name": "HANKE",
        "authorized_official_first_name": "KELSEY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PROVIDER AND OWNER OF BUSINESS",
        "authorized_official_telephone_number": "937-573-8969",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0416206",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; 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.