Active NPI
Duwayne Allen Hansen, M.D.
- Family Medicine Physician
- Fairmont, MN
National Provider Identifier
1881678738
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 20233
- Practice address
- 1861 Knollwood Dr
Fairmont, MN 56031-2303 - Phone
- (507) 238-2985
- NPI assigned
- Dec 5, 2005
- Last updated
- May 29, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20233 | MN | Primary |
Addresses
Primary practice location
1861 Knollwood Dr
Fairmont, MN 56031-2303
Mailing address
1861 Knollwood Dr
Fairmont, MN 56031-2303
Phone (507) 238-2985
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5T521HA | Other | MN | BCBS |
| 20512 | Other | MN | SIOUX VALLEY |
| 959502 | Medicaid | IA | |
| A011 | Other | MN | CHAMPUS |
| 01-13394 | Other | MN | MEDICA |
| 5T521HA | Other | MN | BLUE PLUS |
| HP29868 | Other | MN | HEALTH PARTNERS |
| MH9041000376 | Other | MN | PPO |
| 5T521HA | Other | MN | BCBS/MEDICARE SUPPLEMENT |
| 604587 | Other | MN | ARAZ |
| 7302 | Other | FM | AVERA |
| 39272300 | Medicaid | MN |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20233 | MN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338249600000",
"number": "1881678738",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1861 KNOLLWOOD DR",
"city": "FAIRMONT",
"state": "MN",
"postal_code": "560312303",
"telephone_number": "507-238-2985"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1861 KNOLLWOOD DR",
"city": "FAIRMONT",
"state": "MN",
"postal_code": "560312303",
"telephone_number": "507-238-2985"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSEN",
"first_name": "DUWAYNE",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-12-05",
"last_updated": "2012-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "20233",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "5T521HA",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SIOUX VALLEY",
"identifier": "20512",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "959502",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "A011",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "01-13394",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE PLUS",
"identifier": "5T521HA",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP29868",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PPO",
"identifier": "MH9041000376",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS/MEDICARE SUPPLEMENT",
"identifier": "5T521HA",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARAZ",
"identifier": "604587",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVERA",
"identifier": "7302",
"state": "FM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39272300",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairmont, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.