Jeremy R Hansen, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05011316A Issued in IN

Practice address

225 Crosslake Dr
Evansville, IN 47715-8198

Phone

(812) 477-1558

Fax

(812) 474-2296

NPI assigned

Aug 2, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1375401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392336000000",
    "number": "1457783391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 E INDIANA ST",
            "address_2": "SUITE 102",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477152794",
            "telephone_number": "812-476-0409",
            "fax_number": "812-476-1016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 CROSSLAKE DR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477158198",
            "telephone_number": "812-477-1558",
            "fax_number": "812-474-2296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "JEREMY",
        "middle_name": "R",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-02",
        "last_updated": "2014-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "006252",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05011316A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SHIELD",
            "identifier": "000000845434",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stefan Hanish, OD
• Amy Hanke, PTA
• Jennifer Hanor
• Bryce Hansen, LCSW,
• James Wayne Hansen, M.D., PH.D.
• Lyndsey Hansen, NP
• Keenan D. Hape, OTR
• Happe & Sons Construction, Inc
• Holly M Happe, PA-C
• Jillian Happe

• All providers in Evansville, IN
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2014; 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.