Active NPI
Jennifer L Hanslick, MD
- Neonatal-Perinatal Medicine Physician
- Tulsa, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- 49529
- Practice address
- 1120 S Utica Ave
Suite 2123
Tulsa, OK 74104-4012 - Phone
- (918) 579-5402
- Fax
- (918) 579-5404
- NPI assigned
- Apr 28, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2009012792 | MO | |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | MD177451 | OR | |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 2009012792 | MO | |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 32635 | OK | |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 49529 | CO | Primary |
Addresses
Primary practice location
1120 S Utica Ave
Suite 2123
Tulsa, OK 74104-4012
Mailing address
1120 S Utica Ave
Suite 2123
Tulsa, OK 74104
Phone (918) 579-5402
Other practice location 1
2500 NE Neff Rd
Bend, OR 97701-6015
Phone (541) 382-4321
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200673240A | Medicaid | OK | |
| 50271768 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR, NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 49529 | CO | MD | Neonatal-Perinatal Medicine Physician |
| 32635 | OK | MD | Neonatal-Perinatal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Charles Health System, Inc. | Current | Accepting new patients | |
| St. Charles Health System, Inc. | Current | Accepting new patients | |
| Pokroy Medical Group of Nevada, LTD. | Pediatrics | Current | Accepting new patients |
| St. Charles Health System, Inc. | Current | Accepting new patients | |
| Renown Regional Medical Center | Past | Accepting new patients |
Locations
770 The City Dr S
Ste 4000
Orange, CA 92868
Phone (800) 463-6628
29358 Network Pl
Chicago, IL 60673
3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000
1155 Mill St
Bldg 55
Reno, NV 89502
2500 NE Neff Rd
Bend, OR 97701
Phone (541) 388-4333
1253 NW Canal Blvd
Redmond, OR 97756
Phone (541) 548-8131
Organizations & group practices 5
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.
-
- Neonatal-Perinatal Medicine Physician
- Las Vegas, NV
- NPI 1992809412
Pediatrics
-
- General Acute Care Hospital
- Bend, OR
- NPI 1982621447
-
- Rehabilitation Hospital Unit
- Bend, OR
- NPI 1154343150
-
- Psychiatric Hospital Unit
- Bend, OR
- NPI 1154506814
-
- General Acute Care Hospital
- Reno, NV
- NPI 1124098421
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582675200000",
"number": "1285809632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 S UTICA AVE",
"address_2": "SUITE 2123",
"city": "TULSA",
"state": "OK",
"postal_code": "74104",
"telephone_number": "918-579-5402",
"fax_number": "918-579-5404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 S UTICA AVE",
"address_2": "SUITE 2123",
"city": "TULSA",
"state": "OK",
"postal_code": "741044012",
"telephone_number": "918-579-5402",
"fax_number": "918-579-5404"
}
],
"practiceLocations": [
{
"address_1": "2500 NE Neff Rd",
"address_purpose": "LOCATION",
"city": "Bend",
"state": "OR",
"postal_code": "977016015",
"country_code": "US",
"telephone_number": "541-382-4321",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HANSLICK",
"first_name": "JENNIFER",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-28",
"last_updated": "2020-02-26",
"certification_date": "2020-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2009012792",
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "OR",
"license": "MD177451",
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "MO",
"license": "2009012792",
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "OK",
"license": "32635",
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "CO",
"license": "49529",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200673240A",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "50271768",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.