Individual provider Active NPI

Kristin Lynn Hagar, MD

  • Student in an Organized Health Care Education/Training Program
  • Flint, MI
National Provider Identifier
1003505272
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
4351050906 Issued in MI
Practice address
G3230 Beecher Rd Ste 1
Flint, MI 48532-3604
Phone
(810) 342-5656
Fax
(810) 342-5600
NPI assigned
May 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 4351050906 MI Primary

Addresses

Primary practice location

G3230 Beecher Rd Ste 1
Flint, MI 48532-3604

Mailing address

G3230 Beecher Rd Ste 1
Flint, MI 48532-3604
Phone (810) 342-5656

Other names 1

  • Kristin Lynn Spelde Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230613000485 MI Order and Referring Only - Family PracticePractitioner - Family Practice 8729445341

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Central MichiganGroup PAC ID 6103733092, shared by 21 NPIs, 183 clinicians

Practice addresses (Care Compare)

560 W Mitchell St
Suite C70
Petoskey, MI 49770-2275
Phone (231) 487-7200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4351050906MIMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1683072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1003505272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "G3230 BEECHER RD STE 1",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323604",
            "telephone_number": "810-342-5656",
            "fax_number": "810-342-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "G3230 BEECHER RD STE 1",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323604",
            "telephone_number": "810-342-5656",
            "fax_number": "810-342-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGAR",
        "first_name": "KRISTIN",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-03",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4351050906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "SPELDE",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.