NPIMap

Individual provider Active NPI

Theresa Colleen Hansen

  • Family Nurse Practitioner
  • Creighton, NE
National Provider Identifier
1588021919
Registry record updated Feb 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
111971 Issued in NE
Practice address
1503 Main St
Creighton, NE 68729-3007
Phone
(402) 358-5700
NPI assigned
Jan 15, 2016
Last updated
Feb 24, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 111971 NE Primary

Addresses

Primary practice location

1503 Main St
Creighton, NE 68729-3007

Mailing address

1503 Main St
Creighton, NE 68729-3007
Phone (402) 358-5700

Other names 1

  • Theresa Costello Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190208001296 SD Practitioner - Nurse Practitioner 6507162948 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sacred Heart Health ServicesGroup PAC ID 6103729066, 151 clinicians

Practice addresses (Care Compare)

2525 Fox Run Pkwy
Suite 200
Yankton, SD 57078-5371
Phone (605) 260-2100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Avera Queen of Peace CurrentSince Aug 30, 2023 Accepting new patients
Sacred Heart Health Services CurrentSince Mar 1, 2019 Accepting new patients
Avera Queen of Peace Current Accepting new patients
Avera Queen of Peace CurrentSince Aug 30, 2023 Accepting new patients
Rural Health Care, Inc. Current Accepting new patients
Rural Health Care, Inc CurrentSince Aug 16, 2023 Accepting new patients
Rural Health Care, Inc CurrentSince Aug 16, 2023 Accepting new patients
Sacred Heart Health Services Current Accepting new patients

Locations

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

2525 Fox Run Pkwy
Ste 200
Yankton, SD 57078
Phone (605) 260-2100

501 Summit St
Yankton, SD 57078
Phone (605) 655-1201

Interoperability endpoints

  • Direct secure messaging: theresa.hansen@avera.sdhealthlink.net

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 32

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1452816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456272000000",
    "number": "1588021919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 MAIN ST",
            "city": "CREIGHTON",
            "state": "NE",
            "postal_code": "687293007",
            "telephone_number": "402-358-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 MAIN ST",
            "city": "CREIGHTON",
            "state": "NE",
            "postal_code": "687293007",
            "telephone_number": "402-358-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "THERESA",
        "middle_name": "COLLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-15",
        "last_updated": "2016-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "111971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "COSTELLO",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Creighton, NE

Sources for this page

Verify at the official NPI Registry.