Kimberly Louise Hanks, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA165753 Issued in OR

Practice address

500 5TH St
Brookings, OR 97415-9702

Phone

(541) 412-3000

Fax

(541) 412-2081

NPI assigned

Nov 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Kimberly Louise Hanks Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: khanks249433@samhealth.direct-ci.com

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.

• Albany General Hospital

  • General Acute Care Hospital
  • Albany, OR
  • NPI 1154372340
  Medicare reassignment
• Curry Health District

  • Critical Access Hospital
  • Gold Beach, OR
  • NPI 1487696985
  Medicare reassignment
• Albany General Hospital

  • Family Medicine Physician
  • Albany, OR
  • NPI 1306679816
  NPD
• Albany General Hospital

  • Sleep Disorder Diagnostic Clinic/Center
  • Albany, OR
  • NPI 1700333184
  NPD
• Curry Health District

  • Rural Health Clinic/Center
  • Port Orford, OR
  • NPI 1811939093
  NPD (past)

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1538248018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 5TH ST",
            "city": "BROOKINGS",
            "state": "OR",
            "postal_code": "974159702",
            "telephone_number": "707-382-2921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 5TH ST",
            "city": "BROOKINGS",
            "state": "OR",
            "postal_code": "974159702",
            "telephone_number": "541-412-3000",
            "fax_number": "541-412-2081"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 E Washington Blvd",
            "address_purpose": "LOCATION",
            "city": "Crescent City",
            "state": "CA",
            "postal_code": "955318359",
            "country_code": "US",
            "telephone_number": "707-464-8888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1700 Geary St SE",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "OR",
            "postal_code": "973226842",
            "country_code": "US",
            "telephone_number": "541-812-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANKS",
        "first_name": "KIMBERLY",
        "middle_name": "LOUISE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA15015",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA165753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CURRY MEDICAL CENTER'S NPI",
            "identifier": "1083656367",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CURRY GENERAL HOSPITAL'S NPI",
            "identifier": "1487696985",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500605015",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khanks249433@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "1700 Geary St SE",
            "city": "Albany",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973226842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "HANKS",
            "middle_name": "LOUISE",
            "credential": "P.A.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kristin J Gurholt, O.D.
• Nathaniel Steven Gutierrez, PHARMD
• Kristine Gyving, O.D.
• David Clifford Hall
• Margaret Marie Hall
• Brenda Lee Hansen, PHARMD
• Victoria Hanson
• Kevin Eugene Hardesty, DDS
• Whitney Nichole Harmon
• Harris Beach Emergency Physicians LLC

• Physician Assistant in Brookings, OR
• Providers in Brookings, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.