Active NPI
Gloria Hagberg
- Driver
- Hayward, WI
National Provider Identifier
1033520622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- 39-1519694
- Practice address
- 15856 E 5TH St
Hayward, WI 54843-1827 - Phone
- (715) 634-3000
- Fax
- (715) 634-7501
- NPI assigned
- May 16, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | 39-1519694 | WI | Primary |
Addresses
Primary practice location
15856 E 5TH St
Hayward, WI 54843-1827
Mailing address
15856 E 5TH St
Hayward, WI 54843-1827
Phone (715) 634-3000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39-1519694 | Other | WI | SPECIALIZED TRANSPORTATION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39-1519694 | WI | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400198400000",
"number": "1033520622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15856 E 5TH ST",
"city": "HAYWARD",
"state": "WI",
"postal_code": "548431827",
"telephone_number": "715-634-3000",
"fax_number": "715-634-7501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15856 E 5TH ST",
"city": "HAYWARD",
"state": "WI",
"postal_code": "548431827",
"telephone_number": "715-634-3000",
"fax_number": "715-634-7501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAGBERG",
"first_name": "GLORIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-16",
"last_updated": "2014-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "WI",
"license": "39-1519694",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPECIALIZED TRANSPORTATION",
"identifier": "39-1519694",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hayward, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.