Active NPI
Richard Hagen, OTR/L
- Occupational Therapist
- Heber City, UT
National Provider Identifier
1063899631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 87518764201
- Practice address
- 345 W 600 S
Suite #200
Heber City, UT 84032-2247 - Phone
- (435) 654-5607
- NPI assigned
- May 2, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 87518764201 | UT | Primary |
Addresses
Primary practice location
345 W 600 S
Suite #200
Heber City, UT 84032-2247
Mailing address
345 W 600 S
Suite #200
Heber City, UT 84032-2247
Phone (435) 654-5607
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 87518764201 | UT | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430524800000",
"number": "1063899631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "345 W 600 S",
"address_2": "SUITE #200",
"city": "HEBER CITY",
"state": "UT",
"postal_code": "840322247",
"telephone_number": "435-654-5607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "345 W 600 S",
"address_2": "SUITE #200",
"city": "HEBER CITY",
"state": "UT",
"postal_code": "840322247",
"telephone_number": "435-654-5607"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAGEN",
"first_name": "RICHARD",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-05-02",
"last_updated": "2015-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "UT",
"license": "87518764201",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Heber City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.