Individual provider Active NPI

Robert Samuel Hanna, M.D.

  • Ophthalmology Physician
  • Cherokee, NC
National Provider Identifier
1366456089
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
DR.0023020 Issued in CO
Practice address
1 Hospital Rd
Caller Box C-268
Cherokee, NC 28719-5392
Phone
(828) 497-9163
Fax
(828) 497-1723
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 7567A WY
Ophthalmology Physician 207W00000X DR.0023020 CO Primary

Addresses

Primary practice location

1 Hospital Rd
Caller Box C-268
Cherokee, NC 28719-5392

Mailing address

5165 Grand Cypress CT
Fort Collins, CO 80528-9102
Phone (307) 751-8311

Other practice location 1

5165 Grand Cypress Ct
Fort Collins, CO 80528-9102
Phone (307) 751-8311

Other practice location 2

340 W Dow St
Sheridan, WY 82801-3831
Phone (307) 673-1704

Other identifiers 3

IdentifierTypeStateIssuer
156996001MedicaidAR
207558107OtherMOMISSOURI MEDICAID
P00196059OtherARRAILROAD MEDICARE

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7567AWYMDSpecialist
DR.0023020COMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Eye Associates LTD Ophthalmology PastSince Jan 1, 1990 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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1366456089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5165 GRAND CYPRESS CT",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805289102",
            "telephone_number": "307-751-8311",
            "fax_number": "828-497-1723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL RD",
            "address_2": "CALLER BOX C-268",
            "city": "CHEROKEE",
            "state": "NC",
            "postal_code": "287195392",
            "telephone_number": "828-497-9163",
            "fax_number": "828-497-1723"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5165 Grand Cypress Ct",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805289102",
            "country_code": "US",
            "telephone_number": "307-751-8311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "340 W Dow St",
            "address_purpose": "LOCATION",
            "city": "Sheridan",
            "state": "WY",
            "postal_code": "828013831",
            "country_code": "US",
            "telephone_number": "307-673-1704",
            "fax_number": "307-673-4763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANNA",
        "first_name": "ROBERT",
        "middle_name": "SAMUEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WY",
            "license": "7567A",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CO",
            "license": "DR.0023020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "156996001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI MEDICAID",
            "identifier": "207558107",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00196059",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherokee, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.