Mary Caroniti Hansen, D.O.
Individual provider Active NPI General Practice Physician · Laurel Fork, VA
NPI 1467683243 · NPPES record last updated Jul 21, 2021
Key facts
- NPI
- 1467683243
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 0102203001 (VA)
- Practice address
- 14558 Danville Pike
Laurel Fork, VA 24352-3982 - Phone
- (276) 398-2292
- Fax
- (276) 398-3331
- NPI assigned
- Jul 28, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- General Practice
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Be Well Now
Practice addresses (Care Compare)
188 Ecovillage TRL SE
Floyd, VA 24091-1109
Phone (540) 745-2222
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210804000205 | VA | Practitioner - General Practice | 2769610872 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Be Well Now | Current |
Accepting new patients |
Locations
188 Ecovillage Trl SE
Floyd, VA 24091
Phone (540) 745-2222
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 0102203001 | VA | |
| General Practice Physician | 208D00000X | 0102203001 | VA | Yes |
Addresses
Primary practice location
14558 Danville Pike
Laurel Fork, VA 24352-3982
Mailing address
PO Box 9
Laurel Fork, VA 24352-0009
Phone (276) 398-2292
Other names
- Dr. Mary Catherine Caroniti
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | wedonotusethis |
Other providers in Laurel Fork, VA
- Zetta K Bowles
- Bethany Pearl Brintle
- Cindy Lee Brooms
- Rachel Ellen Carter
- Donna Gibson
- Walter Curtis Hodges Jr.
- Carla T Horton
- Pamela Ruth Hylton
- Tiffany Michelle Jackson
- Laurie Klimczyk
All providers in Laurel Fork, VA · General Practice Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.