Individual provider Active NPI

Danette Florene Hanson, NURSE PRACTITIONER

  • Nurse Practitioner
  • Clarkston, MI
National Provider Identifier
1275779308
Registry record updated Dec 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4707156459 Issued in MI
Practice address
10350 Dartmouth Rd
Clarkston, MI 48348-2115
Phone
(248) 628-1352
NPI assigned
Dec 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4707156459 MI Primary

Addresses

Primary practice location

10350 Dartmouth Rd
Clarkston, MI 48348-2115

Mailing address

10350 Dartmouth Rd
Clarkston, MI 48348-2115
Phone (248) 628-1352

Other identifiers 1

IdentifierTypeStateIssuer
5008661230OtherMIBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090306000553 MI Practitioner - Nurse Practitioner 0143386698 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4707156459MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System CurrentSince Oct 26, 2014 Accepting new patients
Schoolcraft Memorial Hospital CurrentSince Oct 6, 2015 Accepting new patients
Henry Ford Health System Nurse Practitioner CurrentSince Oct 26, 2014 Accepting new patients

Locations

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

468 Cadieux Rd
Grosse Pt Wds, MI 48230
Phone (313) 343-1000

7870W US Highway 2
Manistique, MI 49854
Phone (906) 341-2153

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": "1229558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229558400000",
    "number": "1275779308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 DARTMOUTH RD",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483482115",
            "telephone_number": "248-628-1352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10350 DARTMOUTH RD",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483482115",
            "telephone_number": "248-628-1352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "DANETTE",
        "middle_name": "FLORENE",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-18",
        "last_updated": "2008-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4707156459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5008661230",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, MI

Sources for this page

Verify at the official NPI Registry.