Active NPI
Mary Hanson, NP
- Family Nurse Practitioner
- Brockton, MA
National Provider Identifier
1740275650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 206301
- Practice address
- 1 Pearl St
Ste 1400
Brockton, MA 02301-2864 - Phone
- (508) 897-6030
- Fax
- (508) 897-6015
- NPI assigned
- Sep 16, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 206301 | MA | Primary |
Addresses
Primary practice location
1 Pearl St
Ste 1400
Brockton, MA 02301-2864
Mailing address
1 Pearl St
Ste 1400
Brockton, MA 02301-2864
Phone (508) 897-6030
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0706400 | Medicaid | MA |
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
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740275650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 PEARL ST",
"address_2": "STE 1400",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023012864",
"telephone_number": "508-897-6030",
"fax_number": "508-897-6015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 PEARL ST",
"address_2": "STE 1400",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023012864",
"telephone_number": "508-897-6030",
"fax_number": "508-897-6015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSON",
"first_name": "MARY",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MA",
"license": "206301",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0706400",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.