Individual provider Active NPI

Janet Gail Hansom, MD

  • Family Medicine Physician
  • Mount Vernon, WA
National Provider Identifier
1568465870
Registry record updated Feb 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00029047 Issued in WA
Practice address
2116 East Section Street
Mount Vernon, WA 98274-9124
Phone
(360) 428-1700
Fax
(360) 848-4350
NPI assigned
May 31, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00029047 WA Primary

Addresses

Primary practice location

2116 East Section Street
Mount Vernon, WA 98274-9124

Mailing address

2116 East Section Street
Mount Vernon, WA 98274-9124
Phone (360) 428-1700

Other identifiers 1

IdentifierTypeStateIssuer
8138372MedicaidWA

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

LicenseStateTypeSpecialty
MD00029047WAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298592000000",
    "number": "1568465870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2116 EAST SECTION STREET",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982749124",
            "telephone_number": "360-428-1700",
            "fax_number": "360-848-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 EAST SECTION STREET",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982749124",
            "telephone_number": "360-428-1700",
            "fax_number": "360-848-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSOM",
        "first_name": "JANET",
        "middle_name": "GAIL",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-31",
        "last_updated": "2011-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00029047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8138372",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2011; 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.