NPIMap

Individual provider Active NPI

Phillip Hanson, PT

  • Physical Therapist
  • Medford, OR
National Provider Identifier
1750761979
Registry record updated Dec 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
61496 Issued in OR
Practice address
36 Hawthorne St
Apt 10
Medford, OR 97504-7114
Phone
(541) 776-2333
Fax
(541) 776-2495
NPI assigned
Jun 3, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 61496 OR Primary
Physical Therapist 225100000X 13018-24 WI
Physical Therapist 225100000X 1994 ND

Addresses

Primary practice location

36 Hawthorne St
Apt 10
Medford, OR 97504-7114

Mailing address

36 Hawthorne St
Apt 10
Medford, OR 97504-7114
Phone (541) 776-2333

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

State licenses

LicenseStateTypeSpecialty
13018-24WIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1750761979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 HAWTHORNE ST",
            "address_2": "APT 10",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047114",
            "telephone_number": "541-776-2333",
            "fax_number": "541-776-2495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 HAWTHORNE ST",
            "address_2": "APT 10",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047114",
            "telephone_number": "541-776-2333",
            "fax_number": "541-776-2495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "PHILLIP",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-03",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "61496",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "13018-24",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "1994",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; 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.