NPIMap

Organization Active NPI

Daniel J. Hansen, D.O., PLLC

Doing business as Northern Utah Dermatology

  • Dermatology Physician
  • South Ogden, UT
National Provider Identifier
1447485123
Registry record updated Jul 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
71920331204 Issued in UT
Legal business name
DANIEL J. HANSEN, D.O., PLLC
Doing business as
Northern Utah Dermatology
Practice address
1495 E Ridgeline Dr
South Ogden, UT 84405-4976
Phone
(801) 399-3324
Fax
(801) 394-2807
NPI assigned
May 25, 2009
Last updated
Jul 3, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2015

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

Authorized official

Name
Dr. Daniel Joseph Hansen, D.O.NPI 1114121217
Title
Physician Owner
Phone
(801) 399-3324

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 71920331204 UT
Dermatology Physician 207N00000X 71920331204 UT Primary

Addresses

Primary practice location

1495 E Ridgeline Dr
South Ogden, UT 84405-4976

Mailing address

1495 E Ridgeline Dr
South Ogden, UT 84405-4976
Phone (801) 399-3324

Other names 1

  • Northern Utah Dermatology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090722000339 UT Part B Supplier - Clinic/Group Practice 5496807455 Receives reassigned benefits from 5 practitioners
Practice locations: South Ogden, UT; Syracuse, UT

National Provider Directory

National Provider Directory

Locations

1475 N 2000 W
Ste C
Clinton, UT 84015
Phone (801) 399-3324

1495 E Ridgeline Dr
South Ogden, UT 84405
Phone (801) 399-3324

6028 S Ridgeline Dr
Ste 102
South Ogden, UT 84405
Phone (801) 399-3324

736 S 2000 W
Ste 1
Syracuse, UT 84075
Phone (801) 399-3324

1407 N 2000 W
West Point, UT 84015
Phone (385) 333-7123

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1243209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435881600000",
    "number": "1447485123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1495 E RIDGELINE DR",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844054976",
            "telephone_number": "801-399-3324",
            "fax_number": "801-394-2807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1495 E RIDGELINE DR",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844054976",
            "telephone_number": "801-399-3324",
            "fax_number": "801-394-2807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL J. HANSEN, D.O., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-25",
        "last_updated": "2015-07-03",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "801-399-3324",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "UT",
            "license": "71920331204",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "UT",
            "license": "71920331204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Utah Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.