Benjamin L Hanan, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1359 Issued in WI

Practice address

191 Theatre Rd
Onalaska, WI 54650-8679

Phone

(608) 392-5004

Fax

(608) 392-5791

NPI assigned

Dec 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Interoperability endpoints

• Direct secure messaging: bhanan26147@ehrdirect.mayoclinicmsg.org

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1396805495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 WEST AVE S",
            "address_2": "ATTN PHYSICIAN SERVICES",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546014783",
            "telephone_number": "608-392-4156",
            "fax_number": "608-392-9898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 THEATRE RD",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "546508679",
            "telephone_number": "608-392-5004",
            "fax_number": "608-392-5791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANAN",
        "first_name": "BENJAMIN",
        "middle_name": "L",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "1359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bhanan26147@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "191 Theatre Rd",
            "city": "Onalaska",
            "state": "WI",
            "country_code": "US",
            "postal_code": "546508679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rachelle Rae Guse, MASTERS
• Heather Gustafson, MT
• Anthony Guzman
• Theresa Hagen, CNM, RN, APNP
• Kathie Halverson
• Elizabeth Rose Hansen, M.D.
• Cindy Hanson, OT
• Kimberly Hanson
• Nicole Hanson
• Judith A Harpenau, MD

• Physical Therapy Assistant in Onalaska, WI
• Providers in Onalaska, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.