Jason R Hagerty, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP9396930 Issued in FL

Practice address

1120 10TH St E
Palmetto, FL 34221-4134

Phone

(941) 847-7903

Fax

(941) 847-7919

NPI assigned

Jun 24, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jason.hagerty@wellmed.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Optumcare Florida Ci, LLC

  • Primary Care Clinic/Center
  • Winter Park, FL
  • NPI 1720506603
  NPD (past)

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1073928537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 SUNFOREST DR STE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336346327",
            "telephone_number": "727-824-0780",
            "fax_number": "727-568-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 10TH ST E",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342214134",
            "telephone_number": "941-847-7903",
            "fax_number": "941-847-7919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGERTY",
        "first_name": "JASON",
        "middle_name": "R",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-24",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "OH",
            "license": "COA.16064-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.16064-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9396930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014664800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Greenamoyer
• Ava Greene
• Kathleen Ann Grinde, ARNP
• Natrese Guillory
• Justitia Haddad, OTA
• Christy C Haimes, PHARMD
• Olivia Haley
• Alissa Belmont Hall, MS, CCC-SLP
• Danielle Hall
• Hannah Hall, MS, CCC-SLP

• Family Nurse Practitioner in Palmetto, FL
• Providers in Palmetto, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.