Active NPI
Rolf H Hansen, DPM
- Podiatrist
- Beaver Dam, WI
National Provider Identifier
1821199449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 865025
- Practice address
- 130 Corporate Dr
Beaver Dam, WI 53916-3116 - Phone
- (920) 887-3102
- Fax
- (920) 855-8790
- NPI assigned
- Sep 26, 2006
- Last updated
- Mar 1, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 865025 | WI | Primary |
Addresses
Primary practice location
130 Corporate Dr
Beaver Dam, WI 53916-3116
Mailing address
130 Corporate Dr
Beaver Dam, WI 53916-3116
Phone (920) 887-3102
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821199449 | Medicaid | WI |
Electronic endpoints 4
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rhansen260259@direct-ehr-ssmhc.com | Direct | |
| FHIR URL | https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ | Other | |
| Direct Messaging Address | rhansen260259@direct-ehr-ssmhc.com | Direct | |
| FHIR URL | https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ | Other |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 865025 | WI | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614556800000",
"number": "1821199449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 CORPORATE DR",
"city": "BEAVER DAM",
"state": "WI",
"postal_code": "539163116",
"telephone_number": "920-887-3102",
"fax_number": "920-855-8790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 CORPORATE DR",
"city": "BEAVER DAM",
"state": "WI",
"postal_code": "539163116",
"telephone_number": "920-887-3102",
"fax_number": "920-855-8790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSEN",
"first_name": "ROLF",
"middle_name": "H",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2021-03-01",
"certification_date": "2021-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "WI",
"license": "865025",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1821199449",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rhansen260259@direct-ehr-ssmhc.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "rhansen260259@direct-ehr-ssmhc.com",
"address_1": "705 S University Ave Ste 500",
"city": "Beaver Dam",
"state": "WI",
"country_code": "US",
"postal_code": "539163053",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "FHIR API",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCD",
"address_1": "705 S University Ave Ste 500",
"city": "Beaver Dam",
"state": "WI",
"country_code": "US",
"postal_code": "539163053",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rhansen260259@direct-ehr-ssmhc.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "rhansen260259@direct-ehr-ssmhc.com",
"address_1": "130 Corporate Dr",
"city": "Beaver Dam",
"state": "WI",
"country_code": "US",
"postal_code": "539163116",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "FHIR API",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCD",
"address_1": "130 Corporate Dr",
"city": "Beaver Dam",
"state": "WI",
"country_code": "US",
"postal_code": "539163116",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Beaver Dam, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.