Active NPI
Kenneth D. Hansen, M.D.
- Ophthalmology Physician
- McLean, VA
National Provider Identifier
1518164045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 0101038833
- Practice address
- 6501 Bright Mountain Rd
McLean, VA 22101-1701 - Phone
- (703) 589-7113
- NPI assigned
- Jun 28, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 0101038833 | VA | Primary |
Addresses
Primary practice location
6501 Bright Mountain Rd
McLean, VA 22101-1701
Mailing address
220 108TH Ave
Suite 501
Treasure Island, FL 33706-4753
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101038833 | VA | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1518164045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 108TH AVE",
"address_2": "SUITE 501",
"city": "TREASURE ISLAND",
"state": "FL",
"postal_code": "337064753",
"fax_number": "727-363-2002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6501 BRIGHT MOUNTAIN RD",
"city": "MCLEAN",
"state": "VA",
"postal_code": "221011701",
"telephone_number": "703-589-7113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSEN",
"first_name": "KENNETH",
"middle_name": "D.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "VA",
"license": "0101038833",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McLean, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.