Individual provider Active NPI

Cherissa Carrington Hanson, M.D.

  • Pediatric Critical Care Medicine Physician
  • Raleigh, NC
National Provider Identifier
1649483512
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
200400463 Issued in NC
Practice address
3000 New Bern Ave
Raleigh, NC 27610-1231
Phone
(919) 350-8000
NPI assigned
May 8, 2007
Last updated
Jan 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 200400463 NC Primary

Addresses

Primary practice location

3000 New Bern Ave
Raleigh, NC 27610-1231

Mailing address

PO Box 603949
Charlotte, NC 28260-3949
Phone (919) 350-0351

Other identifiers 1

IdentifierTypeStateIssuer
1649483512MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address chanson85063@directHISP.wakemed.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070817000389 NC Practitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 1557453784 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Wakemed Specialists Group, LLC CurrentSince Aug 22, 2019 Accepting new patients
Wakemed Specialists Group LLC CurrentSince Aug 22, 2019 Accepting new patients
Wakemed Specialists Group, LLC Current Accepting new patients

Locations

1900 Kildaire Farm Rd
Cary, NC 27518
Phone (919) 350-2300

10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300

2920 Highwoods Blvd
Raleigh, NC 27604

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

3024 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-5318

Interoperability endpoints

  • Direct secure messaging: chanson85063@directhisp.wakemed.org

Organizations & group practices 3

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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1649483512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603949",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603949",
            "telephone_number": "919-350-0351",
            "fax_number": "919-350-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 NEW BERN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101231",
            "telephone_number": "919-350-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "CHERISSA",
        "middle_name": "CARRINGTON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NC",
            "license": "200400463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1649483512",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chanson85063@directHISP.wakemed.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "XML",
            "address_1": "3024 New Bern Ave",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276101247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.