Individual provider Active NPI

Robert Hannahan, MD

  • Anesthesiology Physician
  • Enterprise, AL
National Provider Identifier
1720074818
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
20671 Issued in AL
Practice address
1275 James Dr Ste B
Enterprise, AL 36330
Phone
(334) 417-0450
Fax
(801) 315-4946
NPI assigned
Sep 23, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 20671 AL Primary

Addresses

Primary practice location

1275 James Dr Ste B
Enterprise, AL 36330

Mailing address

PO Box 1747
Memphis, TN 38101-1747
Phone (334) 417-0450

Other identifiers 1

IdentifierTypeStateIssuer
000057448MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041229000661 AL Practitioner - Anesthesiology 6709844301 Reassigns benefits to 1 organization
I20231212001395 FL Practitioner - Pain Management 6709844301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Alabama School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1275 James Dr
Suite B
Enterprise, AL 36330-2484
Phone (334) 417-0450

3269 Hwy 90
Bonifay, FL 32425-6001
Phone (251) 599-6445

Hospital & facility affiliations

  • Medical Center Enterprise Hospital, Enterprise, AL, CCN 010049

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20671ALMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wiregrass Podiatry LLC CurrentSince Oct 28, 2023 Accepting new patients
New Horizon Primary Care, LLC PastSince Jun 21, 2020 Accepting new patients
Anesthesia Services PC Anesthesiology Past Accepting new patients

Locations

3657 Montgomery Hwy
Dothan, AL 36303
Phone (334) 494-8200

1275 James Dr
Ste B
Enterprise, AL 36330
Phone (251) 599-6445

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19193/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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.

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": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1720074818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1747",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381011747",
            "telephone_number": "334-417-0450",
            "fax_number": "801-315-4946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 JAMES DR STE B",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "36330",
            "telephone_number": "334-417-0450",
            "fax_number": "801-315-4946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNAHAN",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AL",
            "license": "20671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000057448",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enterprise, AL

Sources for this page

Verify at the official NPI Registry.