Hanson Clinic PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

17496 Issued in CO

Legal business name

HANSON CLINIC PC

Practice address

109 S Burlington Dr
Pueblo West, CO 81007-5560

Phone

(719) 766-9000

Fax

(719) 766-9010

NPI assigned

Jul 12, 2016

Organization subpart

No

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

Authorized official

Name

Annie M Walter

Title

Credentialing Manager

Phone

(719) 766-9004

Specialties & licenses 1

Addresses

Other names 1

• Hanson Clinic MRI Other name

Locations

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468281600000",
    "number": "1851743025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 S BURLINGTON DR",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "810075560",
            "telephone_number": "719-766-9000",
            "fax_number": "719-766-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 S BURLINGTON DR",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "810075560",
            "telephone_number": "719-766-9000",
            "fax_number": "719-766-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANSON CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-12",
        "last_updated": "2016-07-12",
        "status": "A",
        "authorized_official_last_name": "WALTER",
        "authorized_official_first_name": "ANNIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "719-766-9004"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CO",
            "license": "17496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hanson Clinic MRI",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jeremy Michael Halfacre
• Jack E Hall, PA
• Clive Russell Hallam, LMFT
• Talal I Hamki, BS PHARMACY
• Hanson Clinic PC
• Joan L. Hatcher
• Headwaters Dental Management
• Preston Scott Heinen, FNP-C
• Theresa Herrera, NREMT-B IV CERTIFIED
• Melissa Lynn Hollis, COTA

• Specialist in Pueblo West, CO
• Providers in Pueblo West, CO by specialty
• Specialist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.