Individual provider Active NPI

Nosshey F Hanna, MD

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1699877647
Registry record updated Jul 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME0043781 Issued in FL
Practice address
4010 Sunbeam Rd
Jacksonville, FL 32257-6026
Phone
(904) 268-8460
Fax
(904) 268-9809
NPI assigned
Sep 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME0043781 FL Primary
Internal Medicine Physician 207R00000X ME0043721 FL

Addresses

Primary practice location

4010 Sunbeam Rd
Jacksonville, FL 32257-6026

Mailing address

PO Box 551308
Jacksonville, FL 32255-1308
Phone (904) 493-3333

Other identifiers 2

IdentifierTypeStateIssuer
10990OtherFLBCBS
004394200MedicaidFL

Other names 1

  • N. F. Hanna Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100902001148 FL Practitioner - General PracticePractitioner - Family PracticePractitioner - Internal Medicine 8820112493 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0043781FLMDFamily Medicine Physician
ME0043721FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincents Ambulatory Care Inc Internal Medicine CurrentSince Jul 1, 2014 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Jul 1, 2014 Accepting new patients

Locations

9560 Crosshill Blvd
Ste 110
Jacksonville, FL 32222
Phone (904) 203-1296

2563 Oak St
Jacksonville, FL 32204
Phone (904) 388-2619

4010 Sunbeam Rd
Jacksonville, FL 32257
Phone (904) 268-8460

2627 Riverside Ave
Jacksonville, FL 32204
Phone (904) 308-7372

905 Beach Blvd
Jax Bch, FL 32250
Phone (904) 241-8300

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436918400000",
    "number": "1699877647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 551308",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322551308",
            "telephone_number": "904-493-3333",
            "fax_number": "904-493-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 SUNBEAM RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322576026",
            "telephone_number": "904-268-8460",
            "fax_number": "904-268-9809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "NOSSHEY",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2015-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0043781",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0043721",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "10990",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004394200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "N.",
            "last_name": "HANNA",
            "middle_name": "F.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.