MR. TYSON HANSON (NPI# 1457976045) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457976045 |
| Entity Type | Individual |
| Full Name | MR. TYSON HANSON |
| Practice Address |
1496 N 1070 E Sheley ID 83274 |
| Mailing Address |
315 Wind River Dr Shelley ID 83274-2101 |
| Practice Telephone | 2085211837 |
| Mailing Telephone | 2085211837 |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2020-06-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 385HR2060X |
Respite Care Specialization: Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
Respite Care Facility |
| Street Address |
1496 N 1070 E |
| City | SHELEY |
| State | ID |
| Zip Code | 83274 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760631949 | Curtis W Carpenter | Dentist | 295 Anderson Rd, Shelley, ID 83274 | 2008-09-12 |
| 1093908741 | Helmsman Services LLC | Community/Behavioral Health | 175 W. Pine St, Shelley, ID 83274 | 2007-08-24 |
| 1871620906 | John R Stohl | Dentist | 530 S State St, Shelley, ID 83274 | 2007-02-27 |
| 1366542391 | Blackfoot Medical Clinic, Inc | Family Medicine | 210 S Emerson St, Shelley, ID 83274 | 2006-09-22 |
| 1174775902 | Shelley Dental, Inc | Dentist | 530 S State St, Shelley, ID 83274 | 2008-10-10 |
| 1043724990 | Randall Searle | Chiropractor | 120 N Emerson Ave, Shelley, ID 83274-1105 | 2017-11-29 |
| 1215437751 | Elevated Life Family Chiropractic Pllc | Chiropractor | 120 N Emerson Ave, Shelley, ID 83274-1105 | 2018-02-20 |
| 1780784769 | Parkway Eyecare PC | Optometrist | 524 N State St, Shelley, ID 83274-1154 | 2006-09-22 |
| 1962436253 | Travis R Wilkins | Chiropractor | 528 N State St, Shelley, ID 83274-1154 | 2006-07-10 |
| 1871950998 | Jordan Daniel Keck | Chiropractor | 528 N State St, Shelley, ID 83274-1154 | 2016-01-20 |
| Find all providers in zip 83274 | ||||
| Taxonomy Code | 385HR2060X |
| Grouping | Respite Care Facility |
| Classification | Respite Care |
| Specialization | Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
| A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental retardation and/or developmental disabilities as respite for the regular caregivers. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770017303 | Debbie Kay Catanese | Respite Care | 1403 Paul St, Idaho Falls, ID 83401-4229 | 2017-04-20 |
| 1194033746 | Mike Anderson | Respite Care | 618 Nw 1st St, Meridian, ID 83642-2505 | 2010-09-16 |
| 1912264474 | Doris Thornock | Respite Care | 444 N 10th St, Montpelier, ID 83254-1115 | 2012-04-20 |
Please comment or provide details below to improve the information on MR. TYSON HANSON.
| 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.