Individual provider Active NPI

Josiah Hannen

  • Physician Assistant
  • Springboro, OH
National Provider Identifier
1376008136
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2314 Issued in WV
Practice address
325 N Main St Ste 206
Springboro, OH 45066-8005
Phone
(937) 619-0101
NPI assigned
Feb 6, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2314 WV Primary
Physician Assistant 363A00000X 50.005641RX OH

Addresses

Primary practice location

325 N Main St Ste 206
Springboro, OH 45066-8005

Mailing address

2270 Township Road 138
Dillonvale, OH 43917-7942
Phone (724) 312-5963

Other practice location 1

800 Wheeling Ave
Glen Dale, WV 26038-1660
Phone (304) 845-3211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200312002042 WV Practitioner - Physician Assistant 5597193169 Reassigns benefits to 1 organization
I20240215003171 OH Practitioner - Physician Assistant 5597193169 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
79.39 of 100Reported as group
Quality
69.41
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.005641RXOHMDPhysician Assistant

Organizations & group practices 4

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": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1376008136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2270 TOWNSHIP ROAD 138",
            "city": "DILLONVALE",
            "state": "OH",
            "postal_code": "439177942",
            "telephone_number": "724-312-5963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N MAIN ST STE 206",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450668005",
            "telephone_number": "937-619-0101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Wheeling Ave",
            "address_purpose": "LOCATION",
            "city": "Glen Dale",
            "state": "WV",
            "postal_code": "260381660",
            "country_code": "US",
            "telephone_number": "304-845-3211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANNEN",
        "first_name": "JOSIAH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-06",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "2314",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.005641RX",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springboro, OH

Sources for this page

Verify at the official NPI Registry.