Individual provider Active NPI

Teresa Hanson, DNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Waterloo, IA
National Provider Identifier
1659108090
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
G179174 Issued in IA
Practice address
501 Sycamore St
Waterloo, IA 50703-4644
Phone
(319) 433-1445
NPI assigned
Sep 18, 2024
Last updated
Sep 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X G179174 IA Primary

Addresses

Primary practice location

501 Sycamore St
Waterloo, IA 50703-4644

Mailing address

501 Sycamore St
Waterloo, IA 50703-4644
Phone (319) 433-1445

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20241205001014 IA Practitioner - Nurse Practitioner 8123554870 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Black Hawk-Grundy Mental Health Center IncGroup PAC ID 1850280363, 21 clinicians

Practice addresses (Care Compare)

212 W Dale St
Suite 100
Waterloo, IA 50703-1954
Phone (319) 235-3550

233 Vold Dr
Waterloo, IA 50703-1256
Phone 31923550900

3251 W 9TH St
Waterloo, IA 50702-5310
Phone (319) 234-2893

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Black Hawk-Grundy Mental Health Center Inc. CurrentSince Dec 1, 2024 Accepting new patients

Locations

3251 W 9th St
Waterloo, IA 50702
Phone (319) 234-2893

Interoperability endpoints

  • Direct secure messaging: thanson662121@direct.unitypoint.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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1659108090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 SYCAMORE ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507034644",
            "telephone_number": "319-433-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SYCAMORE ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507034644",
            "telephone_number": "319-433-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "TERESA",
        "name_prefix": "Mrs.",
        "credential": "DNP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G179174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.