Basic Information
| Provider Information | |||||||||
| NPI: | 1194700575 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HANSEL | ||||||||
| FirstName: | KEVAN | ||||||||
| MiddleName: | RICHARD | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 360 | ||||||||
| Address2: | |||||||||
| City: | SYLVA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287790360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286933344 | ||||||||
| FaxNumber: | 8286922487 | ||||||||
| Practice Location | |||||||||
| Address1: | 1824 PISGAH DR | ||||||||
| Address2: | |||||||||
| City: | HENDERSONVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287913759 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286948427 | ||||||||
| FaxNumber: | 8286948424 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/08/2005 | ||||||||
| LastUpdateDate: | 04/01/2021 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | M | ||||||||
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| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 04/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 0301121 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 030455058 | 01 | CRESENT | OTHER | N0112A | 05 | SC | MEDICAID | O104246 | 01 | UNITED HEALTHCARE | OTHER | 611186890 | 01 | PRIVATE HEALTHCARE SAVING | OTHER | NC4940C | 01 | NC | MEDICARE | OTHER | 611186890 | 01 | CRESENT | OTHER | 89135A7 | 05 | NC | MEDICAID | NC4940C | 01 | NC | MEDICARE PTAN | OTHER | 030455058 | 01 | HEALTHCARE SAVINGS | OTHER | 611186890 | 01 | CIGNA HEALTHCARE | OTHER | 104250 | 01 | UNITED HEALTHCARE | OTHER | 354567600 | 01 | OWCP | OTHER | 611186890 | 01 | HUMANA TRICARE | OTHER | 611186890 | 01 | BEECH STREET | OTHER | 611186890 | 01 | HEALTHCARE SAVINGS | OTHER | C9476 | 01 | MEDCOST | OTHER | P01403705 | 01 | NC | MEDICARE RR | OTHER | 135A7 | 01 | NC | BCBS | OTHER | C9965 | 01 | MEDCOST | OTHER | 611186890 | 01 | FIRST HEALTH | OTHER |