P Praxis·MD
● Active Type 1 · Individual

Beverly Hanson, PA

Physician Assistant·Blackfoot, ID· NPI 1003874389 · Enumerated 2006 · 20 years on NPI
Hanson is 1 of 2 physician assistant providers in Blackfoot and 1 of 97 in Idaho.
NPI age
20 years
Enumerated 2006-05-03
Primary specialty
Physician Assistant
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2008-09-09
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org

How this provider compares

Across 97 active physician assistant providers in Idaho.

NPI age
20 years
↑ 7 yr above median (13 yr)
State licenses
1 state
23% of peers hold multiple states
Subspecialties
0
56% of peers hold subspecialties

NPI lifetime · 2006 → 2026

2006-05Enumerated in NPPES
2006 2026

Where they practice

Practice location
98 Poplar St
Blackfoot, ID 832211758
📞 2087823993fax 2087823994
Mailing address
98 Poplar St
Blackfoot, ID 832211758
📞 2087823993fax 2087823994

Specialties

  • Physician Assistant Primary
    Definition to come...
    ID license #PAG-012 taxonomy 363AS0400X

Identifiers

TypeValueNotes
01 (ID) 000010167603 RBS LAMERE
01 (ID) HPAC6 BLUE CROSS OLD
01 (ID) PAJ80 BCS LAMERE
01 (ID) 000010154328 REGENCE BLUE SHIELD
01 (ID) HB405 BLUE CROSS
05 (ID) 807338600

Practice context

Part of a multi-provider practice. 107 other active providers share this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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