Glenn a. Hansen, D.P.M.

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

License

403-025 Issued in WI

Legal business name

GLENN A. HANSEN, D.P.M.

Practice address

2331 S Oneida St
Green Bay, WI 54304-5267

Phone

(920) 499-1177

Fax

(920) 499-5398

NPI assigned

Feb 12, 2008

Last updated

Feb 12, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Glenn A. Hansen, D.P.M.NPI 1194732669

Title

Sole Proprietor

Phone

(920) 499-1177

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Glenn A Hansen, D.P.M.

  • Foot Surgery Podiatrist
  • Green Bay, WI
  • NPI 1194732669
  NPD (past) Authorized official

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

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202774400000",
    "number": "1437327475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2331 S ONEIDA ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045267",
            "telephone_number": "920-499-1177",
            "fax_number": "920-499-5398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2331 S ONEIDA ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045267",
            "telephone_number": "920-499-1177",
            "fax_number": "920-499-5398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENN A. HANSEN, D.P.M.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-12",
        "last_updated": "2008-02-12",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "920-499-1177",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "WI",
            "license": "403-025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43217500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura M Gintner, PA-C
• Kelly Jo Gitter, MS CCC
• Karissa A Glass, RN
• Vidalia Glatt
• Mark F Glendenning, PT
• James Michael Glenn, M.D.
• Mark A Glime, D.D.S.
• Bonnie Gene Glinski, PA
• Julie Ann Gloede Phelps, ATC
• Karen Glogauerreich

• Podiatric Clinic/Center in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Podiatric Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; 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.