Individual provider Active NPI

Elizabeth Annette Hannaman

  • Physical Therapy Assistant
  • Blue Springs, MO
National Provider Identifier
1487248498
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2002011005 Issued in MO
Practice address
1704 SW 24TH St
Blue Springs, MO 64015-5255
Phone
(816) 419-0311
NPI assigned
Feb 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2002011005 MO Primary

Addresses

Primary practice location

1704 SW 24TH St
Blue Springs, MO 64015-5255

Mailing address

20511 E Trinity PL
Blue Springs, MO 64015-9501

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2002011005MOMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1613952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1487248498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20511 E TRINITY PL",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640159501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 SW 24TH ST",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640155255",
            "telephone_number": "816-419-0311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNAMAN",
        "first_name": "ELIZABETH",
        "middle_name": "ANNETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-22",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2002011005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Springs, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2021; 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.