NPIMap

Individual provider Active NPI

Kristin Hanson

  • Physical Therapist
  • Biloxi, MS
National Provider Identifier
1346799376
Registry record updated Jun 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT5725 Issued in MS
Practice address
2541 Pass Rd
Suite F
Biloxi, MS 39531
Phone
(228) 388-1002
Fax
(228) 388-1006
NPI assigned
Oct 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT5725 MS Primary

Addresses

Primary practice location

2541 Pass Rd
Suite F
Biloxi, MS 39531

Mailing address

PO Box 8419
Biloxi, MS 39535-8087
Phone (228) 388-5714

Other identifiers 2

IdentifierTypeStateIssuer
09015077MedicaidMS
1033218524OtherMSGROUP NPI

Other names 1

  • Kristen Donnelly Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT5725MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Encore Rehabilitation Inc Past Accepting new patients
Encore Rehabilitation Inc Past Accepting new patients
Encore Rehabilitation Inc Past Accepting new patients
Encore Rehabilitation Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation Inc Past Accepting new patients
Encore Rehabilitation Inc Past Accepting new patients
Encore Rehabilitation Inc Past Accepting new patients
Encore Rehabilitation Inc Past Accepting new patients
Encore Rehabilitation Inc Past Accepting new patients
Encore Rehabiliation Inc Past Accepting new patients
Encore Rehabilitation Inc Past Accepting new patients
Encore Rehabilitation Inc Past Accepting new patients
Encore Rehabilitation Inc Past Accepting new patients
Encore Rehabilitation Inc Past Accepting new patients

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529020800000",
    "number": "1346799376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8419",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395358087",
            "telephone_number": "228-388-5714",
            "fax_number": "228-388-0017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2541 PASS RD",
            "address_2": "SUITE F",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "39531",
            "telephone_number": "228-388-1002",
            "fax_number": "228-388-1006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "KRISTIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-03",
        "last_updated": "2018-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT5725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015077",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1033218524",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "DONNELLY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Biloxi, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2018; 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.