Individual provider Active NPI

Hannah Marie Nixon, PSYCHOLOGIST

  • Psychologist
  • Clancy, MT
National Provider Identifier
1952642696
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4039 Issued in MT
Practice address
325 S Hills Rd
Clancy, MT 59634-9793
Phone
(208) 217-0719
Fax
(208) 625-2070
NPI assigned
Mar 5, 2013
Last updated
Mar 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 202949 ID
Psychologist 103T00000X 4039 MT Primary

Addresses

Primary practice location

325 S Hills Rd
Clancy, MT 59634-9793

Mailing address

325 S Hills Rd
Clancy, MT 59634-9793
Phone (208) 217-0719

Other practice location 1

1301 Pine Ave
Long Beach, CA 90813-3124
Phone (208) 420-4261

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
202949IDMDPsychologist
4039MTMDDermatology Physician

NPI Registry JSON

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

{
    "created_epoch": "1362441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1952642696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 S HILLS RD",
            "city": "CLANCY",
            "state": "MT",
            "postal_code": "596349793",
            "telephone_number": "208-217-0719",
            "fax_number": "208-625-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 S HILLS RD",
            "city": "CLANCY",
            "state": "MT",
            "postal_code": "596349793",
            "telephone_number": "208-217-0719",
            "fax_number": "208-625-2070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 Pine Ave",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908133124",
            "country_code": "US",
            "telephone_number": "208-420-4261",
            "fax_number": "844-807-3782",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIXON",
        "first_name": "HANNAH",
        "middle_name": "MARIE",
        "credential": "PSYCHOLOGIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-05",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ID",
            "license": "202949",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MT",
            "license": "4039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clancy, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; 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.