Individual provider Active NPI

Rebecca Kristine Hanny, ATC

  • Athletic Trainer
  • Beaverton, OR
National Provider Identifier
1225163470
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT-AT-356687 Issued in OR
Practice address
9625 SW 125TH Ave
Beaverton, OR 97008-7755
Phone
(503) 259-5400
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT-AT-356687 OR Primary

Addresses

Primary practice location

9625 SW 125TH Ave
Beaverton, OR 97008-7755

Mailing address

17998 NW Faye CT
Beaverton, OR 97006-4174

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AT-AT-356687ORMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225163470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17998 NW FAYE CT",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970064174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9625 SW 125TH AVE",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970087755",
            "telephone_number": "503-259-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNY",
        "first_name": "REBECCA",
        "middle_name": "KRISTINE",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OR",
            "license": "AT-AT-356687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.