KIMBERLEY A HANNEKEN MD NPI 1215047782

NPI Information

  • NPI: 1215047782
  • Provider Name: KIMBERLEY A HANNEKEN, MD
  • Classification: Family Medicine - 207QA0505X
  • Specialization: Adult Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 260 HOSPITAL DR
    SUITE 209
    UKIAH, CA
    ZIP 95482
  • Phone: (707) 463-7488

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NPI Details

Kimberley A Hanneken, MD is an adult medicine family medicine in Ukiah, CA. The provider is the National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code. Kimberley A Hanneken, MD NPI is 1215047782. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

260 HOSPITAL DR
SUITE 209
UKIAH, CA
ZIP 95482-568
Phone: (707) 463-7488
Fax: (707) 462-7846

The NPI 1215047782 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/30/2006 and was last updated on 8/26/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207QA0505XFamily MedicineAdult Medicine036094217ILLINOISNo
2207QA0505XFamily MedicineAdult MedicineG136098CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1216239OTHERILLINOISMEDICARE GROUP PTAN
2036094217MEDICAIDILLINOIS
31326041229OTHERILLINOISMEDICARE GROUP NPI
4G51652MEDICARE UPINILLINOIS
51043486731OTHERILLINOISHEALTH ALLIANCE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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