Carl Dwayne Hanson Jr., MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

27048 Issued in CO

Practice address

1601 E 19TH Ave
Ste 3450
Denver, CO 80218-1219

Phone

(303) 863-1231

Fax

(303) 869-2085

NPI assigned

Dec 28, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363564800000",
    "number": "1720065055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 E 19TH AVE",
            "address_2": "STE 3450",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802181219",
            "telephone_number": "303-863-1231",
            "fax_number": "303-869-2085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E 19TH AVE",
            "address_2": "STE 3450",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802181219",
            "telephone_number": "303-863-1231",
            "fax_number": "303-869-2085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "CARL",
        "middle_name": "DWAYNE",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2013-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CO",
            "license": "27048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01270487",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elisha Corinne Hanshue, CD
• David William Hanske, DDS MS
• Alan S Hanson, MD
• Ash Hanson
• Brian Hanson, M.D.
• Deanna Therese Hanson, LPC
• Jeffrey Becker Hanson, MD
• Jessica Hanson
• Katherine Hanson, LPC
• Kelsey Irene Hanson, MSW

• Ophthalmology Physician in Denver, CO
• Providers in Denver, CO by specialty
• Ophthalmology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.