Active NPI
Thomas L Hanson, M.D.
- Ophthalmology Physician
- Fargo, ND
National Provider Identifier
1982792297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 4870
- Practice address
- 100 4TH St S Ste 612
Fargo, ND 58103-1940 - Phone
- (701) 235-0561
- Fax
- (701) 235-0330
- NPI assigned
- Oct 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 4870 | ND | Primary |
| Ophthalmology Physician | 207W00000X | 29226 | MN |
Addresses
Primary practice location
100 4TH St S Ste 612
Fargo, ND 58103-1940
Mailing address
100 4TH St S Ste 612
Fargo, ND 58103-1940
Phone (701) 235-0561
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11357 | Other | ND | BLUE SHIELD |
| 2M042HA | Other | MN | BLUE SHIELD |
| 14255 | Medicaid | ND | |
| 892822 | Other | ND | VISION SERVICES |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4870 | ND | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982792297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 4TH ST S STE 612",
"city": "FARGO",
"state": "ND",
"postal_code": "581031940",
"telephone_number": "701-235-0561",
"fax_number": "701-235-0330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 4TH ST S STE 612",
"city": "FARGO",
"state": "ND",
"postal_code": "581031940",
"telephone_number": "701-235-0561",
"fax_number": "701-235-0330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSON",
"first_name": "THOMAS",
"middle_name": "L",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "ND",
"license": "4870",
"primary": true
},
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "MN",
"license": "29226",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "11357",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "2M042HA",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "14255",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VISION SERVICES",
"identifier": "892822",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.