Active NPI
John M Hannam, M.D.
- Neurology Physician
- Omaha, NE
National Provider Identifier
1487678694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 17640
- Practice address
- 10020 Nicholas Street
Suite 202
Omaha, NE 68114-2188 - Phone
- (402) 393-2023
- Fax
- (402) 393-3244
- NPI assigned
- Jul 27, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 17640 | NE | Primary |
Addresses
Primary practice location
10020 Nicholas Street
Suite 202
Omaha, NE 68114-2188
Mailing address
10020 Nicholas Street
Suite 202
Omaha, NE 68114-2188
Phone (402) 393-2023
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01907 | Other | NE | BC/BS GROUP |
| 00748 | Other | NE | BC/BS INDIVIDUAL |
| 130005313 | Other | NE | RR MEDICARE INDIVIDUAL |
| 470542490 | Other | NE | TRICARE GROUP |
| 05-00230 | Other | NE | SHARE ADVANTAGE LAKESIDE |
| 05-00003 | Other | NE | SHARE ADVANTAGE - BERGAN |
| 0931584 | Other | IA | IOWA MEDICAID INDIVIDUAL |
| 47054249012 | Medicaid | NE | |
| 656 | Other | NE | MIDLANDS CHOICE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17640 | NE | MD | Neurology Physician |
Interoperability endpoints
- john.hannam@omahaneuro.directbygreenway.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444694400000",
"number": "1487678694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10020 NICHOLAS STREET",
"address_2": "SUITE 202",
"city": "OMAHA",
"state": "NE",
"postal_code": "681142188",
"telephone_number": "402-393-2023",
"fax_number": "402-393-3244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10020 NICHOLAS STREET",
"address_2": "SUITE 202",
"city": "OMAHA",
"state": "NE",
"postal_code": "681142188",
"telephone_number": "402-393-2023",
"fax_number": "402-393-3244"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANNAM",
"first_name": "JOHN",
"middle_name": "M",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-27",
"last_updated": "2015-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NE",
"license": "17640",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS GROUP",
"identifier": "01907",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS INDIVIDUAL",
"identifier": "00748",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE INDIVIDUAL",
"identifier": "130005313",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE GROUP",
"identifier": "470542490",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SHARE ADVANTAGE LAKESIDE",
"identifier": "05-00230",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SHARE ADVANTAGE - BERGAN",
"identifier": "05-00003",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IOWA MEDICAID INDIVIDUAL",
"identifier": "0931584",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47054249012",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDLANDS CHOICE",
"identifier": "656",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.