Active NPI
Becky Jo Hanna, PA-C
- Medical Physician Assistant
- Springfield, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 085-001617
- Practice address
- 520 N 4TH St
Springfield, IL 62702-5238 - Phone
- (217) 757-8100
- Fax
- (217) 757-8161
- NPI assigned
- Dec 23, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 085-001617 | IL | Primary |
Addresses
Primary practice location
520 N 4TH St
Springfield, IL 62702-5238
Mailing address
PO Box 19670
Springfield, IL 62794-9670
Phone (217) 757-8100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
520 N 4TH St
Springfield, IL 62702-5238
Phone (217) 545-8000
Hospital & facility affiliations
- Memorial Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085-001617 | IL | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Board of Trustees of Southern Illinois University | Current | Accepting new patients | |
| Siu Physicians & Surgeons, Inc | Current | Accepting new patients | |
| Board of Trustees of Southern Illinois University | Current | Accepting new patients | |
| Board of Trustees of Southern Illinois University | Current | Accepting new patients | |
| Siu Physicians & Surgeons, Inc | Past | Accepting new patients |
Locations
751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182
520 N 4th St
Springfield, IL 62702
Phone (217) 757-8100
Interoperability endpoints
- beckyhanna@siusm.allscriptsdirect.net
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Primary Care Clinic/Center
- Springfield, IL
- NPI 1396097960
-
- Rural Health Clinic/Center
- Carbondale, IL
- NPI 1215978127
-
- Federally Qualified Health Center (FQHC)
- Carbondale, IL
- NPI 1568210425
-
- Endocrinology, Diabetes & Metabolism Physician
- Springfield, IL
- NPI 1558385989
-
- Pediatrics Physician
- Springfield, IL
- NPI 1285657379
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Springfield, IL
- NPI 1255317590
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245888000000",
"number": "1477530186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19670",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627949670",
"telephone_number": "217-757-8100",
"fax_number": "217-757-8161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 N 4TH ST",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627025238",
"telephone_number": "217-757-8100",
"fax_number": "217-757-8161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANNA",
"first_name": "BECKY",
"middle_name": "JO",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-23",
"last_updated": "2009-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "IL",
"license": "085-001617",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2009; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.