Individual provider Active NPI

Randy Spencer Hann, PA-C

  • Physician Assistant
  • Safford, AZ
National Provider Identifier
1295018901
Registry record updated Sep 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4958 Issued in AZ
Practice address
1600 S 20TH Ave
Safford, AZ 85546-4011
Phone
(480) 201-6814
NPI assigned
Sep 20, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4958 AZ Primary

Addresses

Primary practice location

1600 S 20TH Ave
Safford, AZ 85546-4011

Mailing address

2018 E Marquette Dr
Gilbert, AZ 85234-3848
Phone (480) 201-6814

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20111130000924 AZ Practitioner - Physician Assistant 5395919328 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gila Health ResourcesGroup PAC ID 1254327216, 28 clinicians

Practice addresses (Care Compare)

401 Burro Aly
Morenci, AZ 85540-9647
Phone (928) 865-7500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4958AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jetmed Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: randy.hann.1@33093.direct.athenahealth.com

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": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316476800000",
    "number": "1295018901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2018 E MARQUETTE DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852343848",
            "telephone_number": "480-201-6814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S 20TH AVE",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "855464011",
            "telephone_number": "480-201-6814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANN",
        "first_name": "RANDY",
        "middle_name": "SPENCER",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-20",
        "last_updated": "2011-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "4958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Safford, AZ

Sources for this page

Verify at the official NPI Registry.