NPIMap

Individual provider Active NPI

Kelly Ann Hanson, NP-C

  • Adult Health Nurse Practitioner
  • Voorhees, NJ
National Provider Identifier
1821479098
Registry record updated Oct 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00569100 Issued in NJ
Practice address
2309 E Evesham Rd
Suite 201
Voorhees, NJ 08043-1559
Phone
(856) 325-5400
NPI assigned
Jun 14, 2015
Last updated
Oct 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NJ00569100 NJ Primary

Addresses

Primary practice location

2309 E Evesham Rd
Suite 201
Voorhees, NJ 08043-1559

Mailing address

301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (856) 355-0340

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address khanson13958@directvirtua.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150929000330 NJ Practitioner - Nurse Practitioner 0143538967 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3906 Church Rd
Mount Laurel, NJ 08054-1108
Phone (856) 552-3261

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.63 of 100Reported as group
Quality
72.06
Improvement activities
40
Cost
72.92

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Jan 28, 2017 Accepting new patients
Virtua Medical Group, PA CurrentSince Jan 28, 2017 Accepting new patients
Samaritan Homevisit Physicians PC Past Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

7000 Atrium Way
Ste 6
Mount Laurel, NJ 08054
Phone (856) 206-4500

2309 E Evesham Rd
Ste 201
Voorhees, NJ 08043
Phone (856) 325-5400

Interoperability endpoints

  • Direct secure messaging: khanson13958@directvirtua.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1434240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602806400000",
    "number": "1821479098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LIPPINCOTT DR STE 410",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534197",
            "telephone_number": "856-355-0340",
            "fax_number": "856-355-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2309 E EVESHAM RD",
            "address_2": "SUITE 201",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080431559",
            "telephone_number": "856-325-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-14",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00569100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khanson13958@directvirtua.org",
            "affiliation": "N",
            "address_1": "2309 E Evesham Rd",
            "address_2": "Suite 201",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080431559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

Verify at the official NPI Registry.