Individual provider Active NPI

Robert Hanson, M.D.

  • Diagnostic Radiology Physician
  • Hermiston, OR
National Provider Identifier
1740217140
Registry record updated Nov 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD11001 Issued in OR
Practice address
610 NW 11TH St
Hermiston, OR 97838-6601
Phone
(541) 667-3520
Fax
(541) 667-3519
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD11001 OR Primary

Addresses

Primary practice location

610 NW 11TH St
Hermiston, OR 97838-6601

Mailing address

PO Box 1359
Klamath Falls, OR 97601-0075
Phone (541) 882-1540

Other identifiers 1

IdentifierTypeStateIssuer
038989MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD11001ORMDDiagnostic Radiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193961600000",
    "number": "1740217140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1359",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976010075",
            "telephone_number": "541-882-1540",
            "fax_number": "541-882-2583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 NW 11TH ST",
            "city": "HERMISTON",
            "state": "OR",
            "postal_code": "978386601",
            "telephone_number": "541-667-3520",
            "fax_number": "541-667-3519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "ROBERT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2007-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "MD11001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038989",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermiston, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.