1194700575 NPI number — MR. KEVAN RICHARD HANSEL MD

Table of content: MR. KEVAN RICHARD HANSEL MD (NPI 1194700575)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194700575 NPI number — MR. KEVAN RICHARD HANSEL MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HANSEL
Provider First Name:
KEVAN
Provider Middle Name:
RICHARD
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194700575
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/01/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 360
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SYLVA
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28779-0360
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-693-3344
Provider Business Mailing Address Fax Number:
828-692-2487

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1824 PISGAH DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HENDERSONVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28791-3759
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-694-8427
Provider Business Practice Location Address Fax Number:
828-694-8424
Provider Enumeration Date:
12/08/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  0301121 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 030455058 . This is a "CRESENT" identifier . This identifiers is of the category "OTHER".
  • Identifier: N0112A , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: O104246 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 611186890 . This is a "PRIVATE HEALTHCARE SAVING" identifier . This identifiers is of the category "OTHER".
  • Identifier: NC4940C . This is a "MEDICARE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 611186890 . This is a "CRESENT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 89135A7 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: NC4940C . This is a "MEDICARE PTAN" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 030455058 . This is a "HEALTHCARE SAVINGS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 611186890 . This is a "CIGNA HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 104250 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 354567600 . This is a "OWCP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 611186890 . This is a "HUMANA TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 611186890 . This is a "BEECH STREET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 611186890 . This is a "HEALTHCARE SAVINGS" identifier . This identifiers is of the category "OTHER".
  • Identifier: C9476 . This is a "MEDCOST" identifier . This identifiers is of the category "OTHER".
  • Identifier: P01403705 . This is a "MEDICARE RR" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 135A7 . This is a "BCBS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: C9965 . This is a "MEDCOST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 611186890 . This is a "FIRST HEALTH" identifier . This identifiers is of the category "OTHER".




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