Provider Demographics
NPI:1932170305
Name:HANSPARD, KENYA (MD)
Entity type:Individual
Prefix:
First Name:KENYA
Middle Name:
Last Name:HANSPARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2168
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29304-2168
Mailing Address - Country:US
Mailing Address - Phone:864-560-4304
Mailing Address - Fax:864-560-4413
Practice Address - Street 1:LAHEY HOSPITAL & MEDICAL CENTER
Practice Address - Street 2:41 MALL ROAD
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01805
Practice Address - Country:US
Practice Address - Phone:781-744-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC24782207P00000X, 207R00000X
MA264837208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP01133062OtherRAILROAD MEDICARE
NC89066UKMedicaid
SC20051871OtherSELECT HEALTH
SCT81710Medicaid
SC189206OtherMEDCOST
SC7068293OtherAETNA
SC189206OtherMEDCOST
SCP00323179Medicare PIN
SCAA95605019Medicare PIN
SCAA95609068Medicare PIN
NC89066UKMedicaid
SCT81710Medicaid
SCH48875Medicare PIN