Individual provider Active NPI

Lee C Hanson, M.D.

  • Internal Medicine Physician
  • Fort Meade, SD
National Provider Identifier
1881666188
Registry record updated May 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2001010350 Issued in MO
Practice address
113 Comanche Rd
Fort Meade, SD 57741-1002
Phone
(605) 499-8137
NPI assigned
Feb 2, 2006
Last updated
May 14, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2001010350 MO
Internal Medicine Physician 207R00000X 2001010350 MO Primary
Hospitalist Physician 208M00000X 2001010350 MO

Addresses

Primary practice location

113 Comanche Rd
Fort Meade, SD 57741-1002

Mailing address

PO Box 285
Fort Meade, SD 57741-0285
Phone (605) 499-8137

Other identifiers 1

IdentifierTypeStateIssuer
205348006MedicaidMO

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)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Red Bud Clinic Corp CurrentSince Sep 1, 2009 Accepting new patients
Dr. Petre I Anguelinin, LLC Internal Medicine PastSince Oct 11, 2020 Accepting new patients
Caduceus Corporation Past Accepting new patients
Alliance Inpatient Medicine Inc Hospitalist Past Accepting new patients

Locations

1335 Jamie Ln
Waterloo, IL 62298
Phone (618) 939-1560

501 Hamacher St
Waterloo, IL 62298
Phone (618) 939-1001

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.

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431561600000",
    "number": "1881666188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 285",
            "city": "FORT MEADE",
            "state": "SD",
            "postal_code": "577410285",
            "telephone_number": "605-499-8137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 COMANCHE RD",
            "city": "FORT MEADE",
            "state": "SD",
            "postal_code": "577411002",
            "telephone_number": "605-499-8137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "LEE",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2015-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2001010350",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2001010350",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2001010350",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205348006",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Meade, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; 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.