David Jeffrey Hanson, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

12647 Issued in GA

Practice address

105 Grand Central Blvd Ste 108
Pooler, GA 31322-4148

Phone

(912) 748-1515

Fax

(844) 807-3782

NPI assigned

Oct 18, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Infinite Medical PCGroup PAC ID 8325477656, 87 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

• Infinite Medical PC

  • Family Medicine Physician
  • Bristol, RI
  • NPI 1407483175

  GA

  Medicare reassignment Care Compare group
• Peachtree Immediate Care FP, LLC

  • Family Medicine Physician
  • Hiram, GA
  • NPI 1437194156
  Medicare reassignment

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

{
    "created_epoch": "1571356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1689217911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 GRAND CENTRAL BLVD STE 108",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224148",
            "telephone_number": "912-748-1515",
            "fax_number": "208-625-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 GRAND CENTRAL BLVD STE 108",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224148",
            "telephone_number": "912-748-1515",
            "fax_number": "844-807-3782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "DAVID",
        "middle_name": "JEFFREY",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-18",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA1806",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA1806",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "12647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA MEDCAL BOARD PA LICENSE",
            "identifier": "12647",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA1806",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tossiana Hamilton
• Catherine E Hamlin, D.M.D.
• Lolita Hanks, FNP-C
• Mark Richard Hannay, MD
• Kristine Leazer Hannifin
• Kaitlin Hare
• Christina Harley, MASSAGE THERAPIST
• Shaniqua Necheryl Harmon, LPC, NCC
• Jada Harris
• Jeffrey William Harris, PMHNP

• Medical Physician Assistant in Pooler, GA
• Providers in Pooler, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.