Judi Hanson

Key facts

NPI

1982139127

Entity type

Individual (NPI type 1)

Primary specialty

Customized Equipment (DME) 332BC3200X

Practice address

611 Ocean Ave
Manzanita, OR 97130-9060

Phone

(503) 368-8637

NPI assigned

Apr 25, 2017

Sex

Female

Sole proprietor

Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Orthopedic Toe Guard Customized Equipment (DME) · Manzanita, OR · NPI 1508396326
  NPD (past) CUSTOMIZED EQUIPMENT

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 25, 2017.

{
    "created_epoch": "1493078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1982139127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 OCEAN AVE",
            "city": "MANZANITA",
            "state": "OR",
            "postal_code": "971309060",
            "telephone_number": "503-368-8637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 OCEAN AVE",
            "city": "MANZANITA",
            "state": "OR",
            "postal_code": "971309060",
            "telephone_number": "503-368-8637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "JUDI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-25",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Manzanita, OR · Customized Equipment (DME) in Oregon