Organization Active NPI

Hanan Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Woodbury, MN
National Provider Identifier
1801526041
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
HANAN HEALTH LLC
Practice address
2042 Wooddale Dr Ste 250-5000
Woodbury, MN 55125-2981
Phone
(612) 662-8999
Fax
(612) 416-8856
NPI assigned
Jun 11, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Authorized official

Name
Asisat Omotayo Ashagbe, APRNNPI 1801343843
Title
Nurse Practitioner
Phone
(240) 593-5653

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

2042 Wooddale Dr Ste 250-5000
Woodbury, MN 55125-2981

Mailing address

2042 Wooddale Dr Ste 250-5000
Woodbury, MN 55125-2981
Phone (651) 381-8720

Other practice location 1

860 Blue Gentian Rd Ste 200
Eagan, MN 55121
Phone (651) 381-8720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221107003113 MN Part B Supplier - Clinic/Group Practice 7810364650 Receives reassigned benefits from 1 practitioner
Practice locations: Eagan, MN; Woodbury, MN

National Provider Directory

National Provider Directory

Locations

2042 Wooddale Dr
Ste 2505000
Woodbury, MN 55125
Phone (612) 424-2038

2042 Wooddale Dr
Ste 250
Woodbury, MN 55125
Phone (651) 300-3328

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1654905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689638400000",
    "number": "1801526041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2042 WOODDALE DR STE 250-5000",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252981",
            "telephone_number": "651-381-8720",
            "fax_number": "612-416-8856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2042 WOODDALE DR STE 250-5000",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252981",
            "telephone_number": "612-662-8999",
            "fax_number": "612-416-8856"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "860 Blue Gentian Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Eagan",
            "state": "MN",
            "postal_code": "55121",
            "country_code": "US",
            "telephone_number": "651-381-8720",
            "fax_number": "612-416-8856",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HANAN HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-11",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A",
        "authorized_official_last_name": "ASHAGBE",
        "authorized_official_first_name": "ASISAT",
        "authorized_official_middle_name": "OMOTAYO",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "240-593-5653",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.