Hanover Medical Specialists, P.a.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

40135 Issued in NC

Legal business name

HANOVER MEDICAL SPECIALISTS, P.A.

Practice address

1515 Doctors Cir
Wilmington, NC 28401-7403

Phone

(910) 763-6332

Fax

(910) 763-0291

NPI assigned

May 27, 2010

Organization subpart

No

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

Authorized official

Name

Paul Kribs

Title

Chief Executive Officer

Phone

(910) 815-0889

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1274918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274918400000",
    "number": "1922327154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 DOCTORS CIR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017403",
            "telephone_number": "910-763-6332",
            "fax_number": "910-763-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 DOCTORS CIR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017403",
            "telephone_number": "910-763-6332",
            "fax_number": "910-763-0291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANOVER MEDICAL SPECIALISTS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-27",
        "last_updated": "2010-05-27",
        "status": "A",
        "authorized_official_last_name": "KRIBS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "910-815-0889"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "40135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01740",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8901740",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Renee Hannah, MA
• Amber Hannon, B.S.
• Scott Q Hannum, M.D.
• Hanover Medical Specialists P a
• Hanover Medical Specialists PA
• Hanover Mental Health, PLLC
• Hanover Pediatrics
• Hanover Primary Care
• Eric Scott Hansberry, MD
• Genevieve R Hansler, MSW, LCSW, LCAS

• Registered Dietitian in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Registered Dietitian in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2010; 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.