Individual provider Active NPI

John Pierrus Hanson Jr., M.D.

  • Hematology & Oncology Physician
  • Milwaukee, WI
National Provider Identifier
1275536450
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
17515 Issued in WI
Practice address
2901 W Kinnickinnic River Pkwy
Ste 415
Milwaukee, WI 53215-3660
Phone
(414) 385-3086
Fax
(414) 672-1985
NPI assigned
May 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 17515 WI Primary

Addresses

Primary practice location

2901 W Kinnickinnic River Pkwy
Ste 415
Milwaukee, WI 53215-3660

Mailing address

2901 W Kinnickinnic River Pkwy
Ste 516
Milwaukee, WI 53215-3660
Phone (414) 385-3086

Other identifiers 1

IdentifierTypeStateIssuer
30917100MedicaidWI

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17515WIMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hematology Oncology Specialty SC Hematology & Oncology Past Accepting new patients
Medical Consultants, LTD. Hematology & Oncology PastSince Jan 1, 1966 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205712000000",
    "number": "1275536450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 W KINNICKINNIC RIVER PKWY",
            "address_2": "STE 516",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153660",
            "telephone_number": "414-385-3086",
            "fax_number": "414-672-1985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 W KINNICKINNIC RIVER PKWY",
            "address_2": "STE 415",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153660",
            "telephone_number": "414-385-3086",
            "fax_number": "414-672-1985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "JOHN",
        "middle_name": "PIERRUS",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2008-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "WI",
            "license": "17515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30917100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; 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.