Kevin Wade-Hanson

Primary specialty

Research Study SpecialistTaxonomy code 1744R1102X

Practice address

10138 W Payson Rd
Tolleson, AZ 85353-8441

Phone

(414) 759-7445

NPI assigned

Dec 5, 2022

Last updated

Jan 4, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1962113548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10138 W PAYSON RD",
            "city": "TOLLESON",
            "state": "AZ",
            "postal_code": "853538441",
            "telephone_number": "414-759-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10138 W PAYSON RD",
            "city": "TOLLESON",
            "state": "AZ",
            "postal_code": "853538441",
            "telephone_number": "414-759-7445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE-HANSON",
        "first_name": "KEVIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-05",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "AZ",
            "license": "D06300831",
            "primary": false
        },
        {
            "code": "1744R1102X",
            "taxonomy_group": "",
            "desc": "Specialist, Research Study",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246ZB0301X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Biomedical Engineering",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246ZB0500X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Biochemist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Research Study Specialist in Tolleson, AZ
• Providers in Tolleson, AZ by specialty
• Research Study Specialist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.