BLAKE HANSEN (NPI# 1285080853) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285080853 |
| Entity Type | Individual |
| Full Name | BLAKE HANSEN |
| Credential | D.O. |
| Practice Address |
4077 Elm Springs Rd Ste 105 Springdale AR 72762-3748 |
| Mailing Address |
4077 Elm Springs Rd Ste 200 Springdale AR 72762-3748 |
| Practice Telephone | 4799272100 |
| Mailing Telephone | 4797578099 |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2020-09-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | E-12376 | AR | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306350186 | Blake Darrell Hansen | Behavior Technician | 475 W 260 N, Orem, UT 84057-1970 | 2017-11-30 |
| 1790218139 | Blake Hansen | Student in an Organized Health Care Education/Training Program | 3100 N Tenaya Way, Graduate Medical Education, Las Vegas, NV 89128-0436 | 2017-04-04 |
| 1518281286 | Blake G Hansen | Social Worker | 640 E Broadway, Jackson, WY 83001 | 2010-03-24 |
| Street Address |
4077 ELM SPRINGS RD STE 105 |
| City | SPRINGDALE |
| State | AR |
| Zip Code | 72762-3748 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497712640 | Jose Albert Ang Fontanilla Jr. | Internal Medicine | 4077 Elm Springs Rd Ste 105, Springdale, AR 72762-3703 | 2006-04-28 |
| 1043704497 | James Robert Feher | Nurse Practitioner | 4077 Elm Springs Rd Ste 105, Springdale, AR 72762-3703 | 2018-06-19 |
| 1609033265 | Carlos Vela Sandoval | Internal Medicine | 4077 Elm Springs Rd Ste 105, Springdale, AR 72762-3748 | 2008-05-21 |
| 1952429680 | Michelle Chua Ang Poland | Family Medicine | 4077 Elm Springs Rd Ste 105, Springdale, AR 72762-3748 | 2007-03-27 |
| 1750316634 | Anna Eremieva | Family Medicine | 4077 Elm Springs Rd Ste 105, Springdale, AR 72762-3703 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861013443 | Samantha G Abbey | Behavior Technician | 6836 Issac's Orchard Rd, Springdale, AR 72762 | 2020-05-05 |
| 1598393605 | Highlands Oncology Group Pa | Pharmacy | 3901 Parkway Circle, Springdale, AR 72762 | 2020-04-01 |
| 1366922320 | Mercy Northwest Arkansas Ambulatory Services LLC | Clinic/Center | 4962 Elm Springs Road, Suite 5, Springdale, AR 72762 | 2018-08-20 |
| 1790281087 | Cheryl Nikol Treat | Nurse Practitioner | 6801 Isaacs Orchard Rd Ste 211, Springdale, AR 72762 | 2018-04-04 |
| 1902304876 | Northwest Arkansas Physical Ability Testing Center, P.a. | Clinic/Center | 4001 Wagon Wheel Road, Springdale, AR 72762 | 2018-01-25 |
| 1609387612 | Rodriguez Dentistry Pllc | Dentist | 1521 Executive Place, Suite A, Springdale, AR 72762 | 2017-10-17 |
| 1306370630 | Medworks LLC | Internal Medicine | 986 Elmwood, Suite C, Springdale, AR 72762 | 2017-04-13 |
| 1790223006 | Sam's West, Inc. | Technician/Technologist | 1517 Gene George Blvd, Springdale, AR 72762 | 2017-02-07 |
| 1255875746 | Arkansas Childrens Northwest, Inc. | General Acute Care Hospital | 2601 South 56th Street, Springdale, AR 72762 | 2016-12-19 |
| 1114473261 | Whitney E Mix | Counselor | 1672 South 48th Street, Suite B, Springdale, AR 72762 | 2016-08-29 |
| Find all providers in zip 72762 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235524869 | William M Rogers | Family Medicine | 513 N. Shiloh Street, Springdale, AR 72764 | 2015-03-31 |
| 1225450026 | Sanford Elmer Hutson IIi | Family Medicine | 506 Fairway Cir, Springdale, AR 72764-1027 | 2014-01-13 |
| 1881035244 | Aaron Zabriskie | Family Medicine | 2158 Butterfield Coach Rd Ste 100, Springdale, AR 72764-9142 | 2013-07-15 |
| 1356780233 | Claire Servy | Family Medicine | 610 E Emma Ave, Suite C, Springdale, AR 72764-4634 | 2013-06-24 |
| 1922361740 | Lynnette Anne Morrison | Family Medicine | 1160 S 40th St, Springdale, AR 72762-4832 | 2012-06-18 |
| 1720374804 | Pierrette Larisse Laure Tantchou | Family Medicine | 813 Founders Park Dr E Ste 101, Springdale, AR 72762-6321 | 2011-06-27 |
| 1053623066 | Matthew Patoka | Family Medicine | 4077 Elm Springs Rd # 105, Springdale, AR 72762-3748 | 2010-07-07 |
| 1053556332 | Sheldon Riklon | Family Medicine | 610 E Emma Ave Ste C, Springdale, AR 72764-4685 | 2008-12-15 |
| 1700058641 | Dorman and Dorman Pa | Family Medicine | 1471 W Sunset Ave, Springdale, AR 72764 | 2008-04-01 |
| 1982876140 | Cassat Family Medicine, Pa | Family Medicine | 1022 Jones Rd, Suite B, Springdale, AR 72762-0705 | 2008-03-27 |
| Find all providers in SPRINGDALE | ||||
| City | SPRINGDALE |
| Zip Code | 72762 |
Please comment or provide details below to improve the information on BLAKE HANSEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.