NPIMap

Individual provider Active NPI

Stephan D Hanna, M.D.

  • Family Medicine Physician
  • Parkersburg, WV
National Provider Identifier
1265480628
Registry record updated Jul 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
13524 Issued in WV
Practice address
1907 Ann St
Parkersburg, WV 26101-2504
Phone
(304) 424-4205
Fax
(304) 424-4485
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 13524 WV Primary

Addresses

Primary practice location

1907 Ann St
Parkersburg, WV 26101-2504

Mailing address

RR 1 Box 256
Washington, WV 26181-9708
Phone (304) 863-3373

Other identifiers 4

IdentifierTypeStateIssuer
000034367OtherBLUE CROSS/BLUE SHIELD
080094477OtherRAILROAD MEDICARE
0541186MedicaidOH
0056732000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080205000376 WV Practitioner - Family Practice 0941262752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia University School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Camden-Clark Physician CorporationGroup PAC ID 5294885661, 345 clinicians

Practice addresses (Care Compare)

1907 Ann St
Parkersburg, WV 26101-2504
Phone (304) 424-4205

Hospital & facility affiliations

  • Adoration Home Health Home health agency, Vienna, WV, CCN 517074
  • Housecalls Home Health Home health agency, Parkersburg, WV, CCN 517114
  • Centerwell Home Health Home health agency, Parkersburg, WV, CCN 517087
  • Wvuhs Home Care Home health agency, Clarksburg, WV, CCN 517053
  • Camden Clark Medical Center Hospital, Parkersburg, WV, CCN 510058
  • Marietta Memorial Hospital Hospital, Marietta, OH, CCN 360147

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Camden-Clark Physician Corporation CurrentSince Nov 1, 2017 Accepting new patients
Camden Clark Memorial Hospital Corporation Past Accepting new patients

Locations

800 Garfield Ave
Parkersburg, WV 26101
Phone (304) 420-7161

1907 Ann St
Parkersburg, WV 26101
Phone (304) 424-4205

800 Garfield Ave
Rm G101
Parkersburg, WV 26101
Phone (304) 422-0405

Organizations & group practices 2

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277942400000",
    "number": "1265480628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 1 BOX 256",
            "city": "WASHINGTON",
            "state": "WV",
            "postal_code": "261819708",
            "telephone_number": "304-863-3373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 ANN ST",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261012504",
            "telephone_number": "304-424-4205",
            "fax_number": "304-424-4485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "STEPHAN",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2010-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "13524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "000034367",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080094477",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0541186",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0056732000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkersburg, WV

Sources for this page

Verify at the official NPI Registry.