Individual provider Active NPI

Dianne M Hansen, RN,C AHN-BC, LMT

  • Nurse Massage Therapist (NMT)
  • Saint Paul, MN
National Provider Identifier
1356653752
Registry record updated Jul 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse Massage Therapist (NMT)Taxonomy code 163WM1400X
License
20040004594 Issued in MN
Practice address
732 Larpenteur Ave W
Saint Paul, MN 55113-6558
Phone
(651) 785-8279
NPI assigned
Jul 14, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Massage Therapist (NMT) 163WM1400X 20040004594 MN Primary
Nutrition Support Registered Nurse 163WN1003X R110668-6 MN
Rehabilitation Registered Nurse 163WR0400X R110668-6 MN

Addresses

Primary practice location

732 Larpenteur Ave W
Saint Paul, MN 55113-6558

Mailing address

1769 Lexington Ave N
N #236
Saint Paul, MN 55113-6522
Phone (651) 785-8279

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
20040004594MNMDNurse Massage Therapist (NMT)
R110668-6MNMDNutrition Support Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Livewell Health, LLC Nutrition Support Past Accepting new patients

Organizations & group practices 1

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": "1279065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279065600000",
    "number": "1356653752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1769 LEXINGTON AVE N",
            "address_2": "N #236",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551136522",
            "telephone_number": "651-785-8279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 LARPENTEUR AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551136558",
            "telephone_number": "651-785-8279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "DIANNE",
        "middle_name": "M",
        "credential": "RN,C AHN-BC, LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-14",
        "last_updated": "2010-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM1400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nurse Massage Therapist (NMT)",
            "state": "MN",
            "license": "20040004594",
            "primary": true
        },
        {
            "code": "163WN1003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nutrition Support",
            "state": "MN",
            "license": "R110668-6",
            "primary": false
        },
        {
            "code": "163WR0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Rehabilitation",
            "state": "MN",
            "license": "R110668-6",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2010; 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.