Active NPI
Kyle Hannan
- Developmental Therapist
- Gretna, LA
National Provider Identifier
1932545845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- License
- 010133001
- Practice address
- 326 Brett Dr
Gretna, LA 70056-7214 - Phone
- (504) 309-5867
- NPI assigned
- May 18, 2013
- 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 |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | 010133001 | LA | Primary |
Addresses
Primary practice location
326 Brett Dr
Gretna, LA 70056-7214
Mailing address
326 Brett Dr
Gretna, LA 70056-7214
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 |
|---|---|---|---|
| 010133001 | LA | MD | Developmental Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368835200000",
"number": "1932545845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "326 BRETT DR",
"city": "GRETNA",
"state": "LA",
"postal_code": "700567214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "326 BRETT DR",
"city": "GRETNA",
"state": "LA",
"postal_code": "700567214",
"telephone_number": "504-309-5867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANNAN",
"first_name": "KYLE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-05-18",
"last_updated": "2013-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "LA",
"license": "010133001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gretna, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.