Active NPI
Stanley Melvin Hatesohl, M.D.
- Family Medicine Physician
- Hot Springs Village, AR
National Provider Identifier
1396793741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- E-13524
- Practice address
- 410 Ponce de Leon Dr
Hot Springs Village, AR 71909-8121 - Phone
- (501) 922-1700
- Fax
- (501) 922-0826
- NPI assigned
- May 5, 2006
- Last updated
- Sep 28, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 21750 | KS | |
| Family Medicine Physician | 207Q00000X | E-13524 | AR | Primary |
Addresses
Primary practice location
410 Ponce de Leon Dr
Hot Springs Village, AR 71909-8121
Mailing address
PO Box 21850
Hot Springs, AR 71903-1850
Phone (870) 904-2807
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100206090B | Medicaid | KS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Kansas School of Med (KC/Wich/Sal), 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
711 Liberty St
Clay Center, KS 67432-1528
P O Box
Suite 21850
Hot Springs, AR 71903-1850
PO Box
Hot Springs, AR 71903
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-13524 | AR | MD | Family Medicine Physician |
| 21750 | KS | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Kansas Medical Park Ancillary Services, P.a. | Family Medicine | Current | Accepting new patients |
Locations
1309 Polk St
Great Bend, KS 67530
Phone (620) 792-5341
Interoperability endpoints
- shatesohl1063399@directb.mercy.net
- stanley.hatesohl@khindirect.org
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Medical Laboratory
- Great Bend, KS
- NPI 1710988134
Family Medicine
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Hot Springs, AR
- NPI 1316144546
-
- General Practice Physician
- Hot Springs, AR
- NPI 1497880124
Hospital
-
- Psychiatric Hospital Unit
- Hot Springs, AR
- NPI 1619915949
-
- General Acute Care Hospital
- Hot Springs, AR
- NPI 1689628232
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601251200000",
"number": "1396793741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 21850",
"city": "HOT SPRINGS",
"state": "AR",
"postal_code": "719031850",
"telephone_number": "870-904-2807",
"fax_number": "501-321-4057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 PONCE DE LEON DR",
"city": "HOT SPRINGS VILLAGE",
"state": "AR",
"postal_code": "719098121",
"telephone_number": "501-922-1700",
"fax_number": "501-922-0826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HATESOHL",
"first_name": "STANLEY",
"middle_name": "MELVIN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-05",
"last_updated": "2020-09-28",
"certification_date": "2020-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KS",
"license": "21750",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AR",
"license": "E-13524",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100206090B",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hot Springs Village, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.