NPIMap

Individual provider Active NPI

John Han, MD

  • Internal Medicine Physician
  • Longview, TX
National Provider Identifier
1396125985
Registry record updated Jun 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
BP10053891 Issued in TX
Practice address
700 E Marshall Ave
Longview, TX 75601-5580
Phone
(903) 315-2000
NPI assigned
Jun 9, 2015
Last updated
Jun 5, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X BP10053891 TX Primary

Addresses

Primary practice location

700 E Marshall Ave
Longview, TX 75601-5580

Mailing address

PO Box 846098
Dallas, TX 75284-6098
Phone (903) 324-6400

Other identifiers 2

IdentifierTypeStateIssuer
410036401MedicaidTX
8MM893OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211201001906 KY Practitioner - Internal Medicine 6608175880 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Southwestern Medical School at Dallas, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Saint Joseph Dr
Lexington, KY 40504-3742
Phone (859) 313-1000

150 N Eagle Creek Dr
Lexington, KY 40509-1805
Phone (859) 967-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of Kentucky, PSC Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients
Baptist Health Medical Group Inc Internal Medicine CurrentSince Dec 1, 2021 Accepting new patients
Baptist Health Medical Group Inc Current Accepting new patients
Pikeville Medical Center Inc. CurrentSince Nov 3, 2021 Accepting new patients
Hospitalist Medicine Physicians of Indiana, LLC Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients
Pikeville Medical Center Inc CurrentSince Nov 3, 2021 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Dec 1, 2021 Accepting new patients
Saint Joseph Health System, Inc Past Accepting new patients

Locations

150 N Eagle Creek Dr
Lexington, KY 40509
Phone (859) 267-9773

4071 Tates Creek Centre Dr
Ste 202
Lexington, KY 40517
Phone (859) 260-4390

1001 Saint Joseph Ln
London, KY 40741
Phone (606) 330-6000

184 S Mayo Trl
Pikeville, KY 41501
Phone (606) 430-2213

911 Bypass Rd
Pikeville, KY 41501
Phone (606) 218-4530

911 Bypass Rd
Bldg A
Pikeville, KY 41501
Phone (606) 430-2201

801 Eastern Byp
Richmond, KY 40475
Phone (606) 623-3131

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591315200000",
    "number": "1396125985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846098",
            "telephone_number": "903-324-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E MARSHALL AVE",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015580",
            "telephone_number": "903-315-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAN",
        "first_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-09",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10053891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "410036401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8MM893",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.