Kim Hannigan, PHD, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

306198 Issued in OR

Practice address

214 Langton Hall
Corvallis, OR 97331-8534

Phone

(541) 737-5314

NPI assigned

Dec 6, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1544054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1922579747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 LANGTON HALL",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973318534",
            "telephone_number": "541-737-5314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 LANGTON HALL",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973318534",
            "telephone_number": "541-737-5314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNIGAN",
        "first_name": "KIM",
        "credential": "PHD, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-06",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OR",
            "license": "306198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Hanks
• Kourtney L Hanks, CNM/FNP
• Susan C Hanley
• Loren Stan Hanna IV, DC
• Angela Hannigan, MA, CCC-SLP
• Aleksander W Hansen, DO
• Anne Lusignan Hansen, RN
• Dylan Anthony Hansen
• Mary Catherine Hansen, DO
• Warner Mathew Hansen

• Athletic Trainer in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Athletic Trainer in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.