Terry Milo Hansen, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

109507-9934 Issued in UT

Practice address

2828 West 4700 South
Suite D
West Valley City, UT 84118

Phone

(801) 966-6201

Fax

(801) 966-6609

NPI assigned

Nov 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417028952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 WEST 4700 SOUTH",
            "address_2": "SUITE D",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "84118",
            "telephone_number": "801-966-6201",
            "fax_number": "801-966-6609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 WEST 4700 SOUTH",
            "address_2": "SUITE D",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "84118",
            "telephone_number": "801-966-6201",
            "fax_number": "801-966-6609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "TERRY",
        "middle_name": "MILO",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1040",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "109507-9934",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "109507-8908",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "519520390009",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Camryn Hamilton
• Breeann Berger Hamp, CSW
• Hanai Family Services LLC
• Andrew Hansen, PA-C
• Kyle D Hansen, PHARMD
• Timothy Hansen
• Jamie Elise Hanson, M.D.
• Christina Kathryn Harden, LCSW
• Glenna J Hardy, RN
• Harmon City Inc

• Optometrist in West Valley City, UT
• Providers in West Valley City, UT by specialty
• Optometrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.