Active NPI
Steven P Hansen, D.C.
- Chiropractor
- De Pere, WI
National Provider Identifier
1992872071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3652-012
- Practice address
- 111 N 5TH St
De Pere, WI 54115-2201 - Phone
- (920) 336-9355
- Fax
- (920) 336-9358
- NPI assigned
- Nov 30, 2006
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3652-012 | WI | Primary |
Addresses
Primary practice location
111 N 5TH St
De Pere, WI 54115-2201
Mailing address
111 N 5TH St
De Pere, WI 54115-2201
Phone (920) 336-9355
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38926100 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 1999
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
500 Main Ave a
De Pere, WI 54115-2211
Phone (920) 336-9355
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3652-012 | WI | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Back in Action Chiropractic Center, LLC | Chiropractor | Current | Accepting new patients |
| Back to Basics Health Center SC | Chiropractor | Past | Accepting new patients |
| A & E Integrated Health, S.C. | Past | Accepting new patients | |
| Allied Health of Wisconsin, SC | Chiropractor | Past | Accepting new patients |
Locations
111 N 5th St
De Pere, WI 54115
Phone (920) 336-9355
500 Main Ave
Ste A
De Pere, WI 54115
Phone (920) 336-9355
Organizations & group practices 4
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.
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- Chiropractor
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992872071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 N 5TH ST",
"city": "DE PERE",
"state": "WI",
"postal_code": "541152201",
"telephone_number": "920-336-9355",
"fax_number": "920-336-9358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 N 5TH ST",
"city": "DE PERE",
"state": "WI",
"postal_code": "541152201",
"telephone_number": "920-336-9355",
"fax_number": "920-336-9358"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSEN",
"first_name": "STEVEN",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WI",
"license": "3652-012",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38926100",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in De Pere, WI
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.