Randall Tyler Hansen, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

8699702-1204 Issued in UT

Practice address

475 W 940 N
Provo, UT 84604-3301

Phone

(801) 357-7930

Fax

(801) 357-7014

NPI assigned

May 17, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health Home Health - St. George Home health agency, St George, UT, CCN 467033
• St. George Regional Hospital Hospital, St George, UT, CCN 460021
• Intermountain Health Cedar City Hospital Hospital, Cedar City, UT, CCN 460007

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Ihc Health Services Inc

  dba IMED Physicians Billing

  • Multi-Specialty Clinic/Center
  • Murray, UT
  • NPI 1629260880

  Family Medicine

  Medicare reassignment NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment NPD
• Ihc Health Services Inc

  dba LDS Maternal Fetal Medicine

  • Maternal & Fetal Medicine Physician
  • Salt Lake City, UT
  • NPI 1053610196
  NPD
• Ihc Health Services Inc

  dba Dixie Regional Sleep Disorders Center

  • Multi-Specialty Clinic/Center
  • St George, UT
  • NPI 1447486071
  NPD
• Ihc Health Services, Inc.

  dba St George Adolescent Partial Hospitalization

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Ihc Health Services Inc

  dba Orem Community Hospital Physicians

  • Multi-Specialty Clinic/Center
  • Orem, UT
  • NPI 1588601124
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ihc Health Services Inc

  dba Intermountain Health Home Health Cedar City

  • Home Health Agency
  • St George, UT
  • NPI 1932270246
  Care Compare affiliation
• Ihc Health Services, Inc.

  dba Intermountain Health St. George Regional Hospital

  • General Acute Care Hospital
  • St George, UT
  • NPI 1366452880
  Care Compare affiliation
• Ihc Health Services, Inc.

  dba Intermountain Health Cedar City Hospital

  • General Acute Care Hospital
  • Cedar City, UT
  • NPI 1538178801
  Care Compare affiliation

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

{
    "created_epoch": "1337212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453420800000",
    "number": "1831459361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 W 940 N",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043301",
            "telephone_number": "801-357-7930",
            "fax_number": "801-357-7014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 W 940 N",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043301",
            "telephone_number": "801-357-7930",
            "fax_number": "801-357-7014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "RANDALL",
        "middle_name": "TYLER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-17",
        "last_updated": "2016-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "8699702-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Conway Hansen, PA-C
• Joshua Jordan Hansen
• Madeline Claire Hansen, BS
• Matthew C. Hansen
• Racquel Lyn Hansen, ATC
• Rebecca L Hansen
• Samantha Hansen
• Samantha Rose Hansen
• Samuel Jacob Hansen
• Sarina Hansen

• Family Medicine Physician in Provo, UT
• Providers in Provo, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.