Individual provider Active NPI

Hannah Ann Hanks, DPT

  • Physical Therapist
  • Eagle, ID
National Provider Identifier
1619690690
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-8191 Issued in ID
Practice address
775 S Rivershore LN Ste 220
Eagle, ID 83616-5783
Phone
(208) 629-1030
NPI assigned
Sep 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-8191 ID Primary

Addresses

Primary practice location

775 S Rivershore LN Ste 220
Eagle, ID 83616-5783

Mailing address

775 S Rivershore LN Ste 220
Eagle, ID 83616-5783
Phone (208) 629-1030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221017001499 ID Practitioner - Physical Therapist in Private Practice 2062888076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Treasure Valley Pelvic Health LLCGroup PAC ID 4789929431, 9 clinicians

Practice addresses (Care Compare)

775 S Rivershore LN
Suite 220
Eagle, ID 83616-5783
Phone (208) 629-1030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-8191IDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Treasure Valley Pelvic Health, LLC Physical Therapist CurrentSince Jul 21, 2025 Accepting new patients
Scolispine PLLC Physical Therapist PastSince Sep 23, 2022 Accepting new patients

Locations

2717 W Bannock St
Ste 100
Boise, ID 83702
Phone (208) 629-1030

775 S Rivershore Ln
Ste 220
Eagle, ID 83616
Phone (208) 435-8662

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1663891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1619690690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 S RIVERSHORE LN STE 220",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165783",
            "telephone_number": "208-629-1030",
            "fax_number": "208-346-7618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 S RIVERSHORE LN STE 220",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165783",
            "telephone_number": "208-629-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANKS",
        "first_name": "HANNAH",
        "middle_name": "ANN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-23",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-8191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.