Active NPI
Michael J Hanson, RPT
- Physical Therapist
- Nashville, IL
National Provider Identifier
1891042321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070004333
- Practice address
- 485 S Friendship Dr
Nashville, IL 62263-1363 - Phone
- (618) 327-3041
- NPI assigned
- Aug 15, 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070004333 | IL | Primary |
Addresses
Primary practice location
485 S Friendship Dr
Nashville, IL 62263-1363
Mailing address
3801 Old Bruceville Rd
Vincennes, IN 47591-3889
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070004333 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344988800000",
"number": "1891042321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3801 OLD BRUCEVILLE RD",
"city": "VINCENNES",
"state": "IN",
"postal_code": "475913889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "485 S FRIENDSHIP DR",
"city": "NASHVILLE",
"state": "IL",
"postal_code": "622631363",
"telephone_number": "618-327-3041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSON",
"first_name": "MICHAEL",
"middle_name": "J",
"credential": "RPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-08-15",
"last_updated": "2012-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070004333",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nashville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.