Individual provider Active NPI

Gina M Hagar, PSYD

  • Clinical Psychologist
  • Black Mountain, NC
National Provider Identifier
1083855423
Registry record updated Jun 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3730 Issued in NC
Practice address
611 Old US Hwy 70 E
Black Mountain, NC 28711-9488
Phone
(925) 451-3144
Fax
(828) 665-7062
NPI assigned
Mar 16, 2009
Last updated
Jun 23, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3730 NC Primary

Addresses

Primary practice location

611 Old US Hwy 70 E
Black Mountain, NC 28711-9488

Mailing address

PO Box 263
Candler, NC 28715-0263
Phone (925) 451-3144

Other identifiers 1

IdentifierTypeStateIssuer
6001137MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091113000384 NC Practitioner - Clinical Psychologist 7517005424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

611 Old US Hwy 70 E
Black Mountain, NC 28711-9488
Phone (828) 665-7062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Geripsych Services PLLC Clinical CurrentSince Mar 26, 2012 Accepting new patients

Locations

611 Old US Hwy 70 E
Black Mtn, NC 28711
Phone (828) 665-7062

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1237161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435017600000",
    "number": "1083855423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 263",
            "city": "CANDLER",
            "state": "NC",
            "postal_code": "287150263",
            "telephone_number": "925-451-3144",
            "fax_number": "828-665-7062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 OLD US HWY 70 E",
            "city": "BLACK MOUNTAIN",
            "state": "NC",
            "postal_code": "287119488",
            "telephone_number": "925-451-3144",
            "fax_number": "828-665-7062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGAR",
        "first_name": "GINA",
        "middle_name": "M",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-16",
        "last_updated": "2015-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "3730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6001137",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Black Mountain, NC

Sources for this page

Verify at the official NPI Registry.