Individual provider Active NPI

Mary J Hager, OTR

  • Occupational Therapist
  • Charleston, WV
National Provider Identifier
1164632592
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
005 Issued in WV
Practice address
200 Elizabeth St
Charleston, WV 25311-2119
Phone
(304) 348-7740
NPI assigned
May 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 005 WV Primary
Local Education Agency (LEA) 251300000X 005 WV

Addresses

Primary practice location

200 Elizabeth St
Charleston, WV 25311-2119

Mailing address

5310 Edgebrook Dr
Cross Lanes, WV 25313-1725
Phone (304) 776-4515

Other identifiers 1

IdentifierTypeStateIssuer
00401730121MedicaidWV

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

LicenseStateTypeSpecialty
005WVMDLocal Education Agency (LEA)

Practice roles

OrganizationSpecialtyStatusNew patients
Kanawha County Schools Local Education Agency (Lea) Past Accepting new patients
Kanawha County Schools Local Education Agency (Lea) Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1164632592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 EDGEBROOK DR",
            "city": "CROSS LANES",
            "state": "WV",
            "postal_code": "253131725",
            "telephone_number": "304-776-4515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ELIZABETH ST",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253112119",
            "telephone_number": "304-348-7740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGER",
        "first_name": "MARY",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WV",
            "license": "005",
            "primary": true
        },
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "WV",
            "license": "005",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00401730121",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.