Individual provider Active NPI

Charles D Hanshaw, DO

  • Internal Medicine Physician
  • Dayton, OH
National Provider Identifier
1871523209
Registry record updated Nov 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34003234H Issued in OH
Practice address
8940 Kingsridge Dr
Ste. 103
Dayton, OH 45458-1632
Phone
(937) 439-7430
Fax
(937) 439-7446
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34003234H OH Primary

Addresses

Primary practice location

8940 Kingsridge Dr
Ste. 103
Dayton, OH 45458-1632

Mailing address

8940 Kingsridge Dr
Ste. 103
Dayton, OH 45458-1632
Phone (937) 439-7430

Other identifiers 1

IdentifierTypeStateIssuer
0466320MedicaidOH

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20100225000590 OH Practitioner - Internal Medicine 1254364755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.14 of 100Reported as group
Quality
93.85
Promoting interoperability
100
Improvement activities
40
Cost
79.94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34003234HOHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charles D Hanshaw DO Inc Internal Medicine CurrentSince Jul 15, 2000 Accepting new patients
Alliance Physicians Inc Internal Medicine Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Kaiser Medical Corporation Past Accepting new patients

Locations

8940 Kingsridge Dr
Ste 103
Dayton, OH 45458
Phone (937) 439-7430

8940 Kingsridge Dr
Dayton, OH 45458
Phone (937) 434-9149

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8833/brand/1/csg/1/fhir/r4
  • Direct secure messaging: charles.hanshaw.1@8833.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447891200000",
    "number": "1871523209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8940 KINGSRIDGE DR",
            "address_2": "STE. 103",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454581632",
            "telephone_number": "937-439-7430",
            "fax_number": "937-439-7446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8940 KINGSRIDGE DR",
            "address_2": "STE. 103",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454581632",
            "telephone_number": "937-439-7430",
            "fax_number": "937-439-7446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSHAW",
        "first_name": "CHARLES",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2015-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34003234H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0466320",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.