Individual provider Active NPI

Ivo Kekoa Hanza, APRN

  • Family Nurse Practitioner
  • St George, UT
National Provider Identifier
1740605963
Registry record updated Feb 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
6430990-4405 Issued in UT
Practice address
1490 E Foremaster Dr
St George, UT 84790-4488
Phone
(435) 628-1641
Fax
(435) 628-1660
NPI assigned
Feb 25, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 6430990-4405 UT Primary

Addresses

Primary practice location

1490 E Foremaster Dr
St George, UT 84790-4488

Mailing address

652 S 600 E Apt 4
St George, UT 84770-3762
Phone (435) 216-6686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140502001876 UT Practitioner - Nurse Practitioner 1658504337 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

1380 E Medical Ctr Dr
St George, UT 84790-2123
Phone (435) 251-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6430990-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services, Inc. CurrentSince Nov 19, 2018 Accepting new patients
St. George Radiology Inc. CurrentSince Jun 1, 2016 Accepting new patients
Ihc Health Services Inc CurrentSince Nov 19, 2018 Accepting new patients

Locations

1490 E Foremaster Dr
St George, UT 84790
Phone (435) 674-5230

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

1490 E Foremaster Dr
Ste 200
St George, UT 84790
Phone (435) 528-1641

1308 E 900 S
Ste C
St George, UT 84790
Phone (435) 673-2301

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 2

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": "1393286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393286400000",
    "number": "1740605963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "652 S 600 E APT 4",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847703762",
            "telephone_number": "435-216-6686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 E FOREMASTER DR",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847904488",
            "telephone_number": "435-628-1641",
            "fax_number": "435-628-1660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANZA",
        "first_name": "IVO",
        "middle_name": "KEKOA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-25",
        "last_updated": "2014-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "6430990-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.