Carl Arthur Hansen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2364 Issued in WV

Practice address

215 North Court St
Fayetteville, WV 25840

Phone

(304) 574-1363

Fax

(304) 574-1363

NPI assigned

Nov 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Nov 18, 2015 through Nov 18, 2027

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922171024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 508",
            "address_2": "215 N COURT",
            "city": "FAYETTEVILLE",
            "state": "WV",
            "postal_code": "25840",
            "telephone_number": "304-574-1363",
            "fax_number": "304-574-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 NORTH COURT ST",
            "city": "FAYETTEVILLE",
            "state": "WV",
            "postal_code": "25840",
            "telephone_number": "304-574-1363",
            "fax_number": "304-574-1363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "CARL",
        "middle_name": "ARTHUR",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "2364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0135245000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Grudzinski
• James L Hall
• Leslie J Hall
• Courtney Nicole Hamilton, MS
• Madeline Hanner
• Tammy Gail Harper
• Lisa E Harris, P.T.
• Adriane M Heatherly, NCC
• Christopher Michael Hill, MD
• Selena Hoye

• General Practice Dentistry in Fayetteville, WV
• Providers in Fayetteville, WV by specialty
• General Practice Dentistry in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.