Individual provider Active NPI

Lorie Lanette Hagl, PT

  • Physical Therapist
  • Saint Louis, MO
National Provider Identifier
1225173776
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
100391 Issued in MO
Practice address
1170 Timber Run Dr
Saint Louis, MO 63146-4482
Phone
(314) 469-0606
Fax
(314) 469-3294
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 100391 MO Primary

Addresses

Primary practice location

1170 Timber Run Dr
Saint Louis, MO 63146-4482

Mailing address

49 Gary Glen Dr
Saint Peters, MO 63376-1952
Phone (636) 397-7735

Other identifiers 1

IdentifierTypeStateIssuer
4487786022MedicaidMO

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
100391MOMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225173776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 GARY GLEN DR",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761952",
            "telephone_number": "636-397-7735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 TIMBER RUN DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631464482",
            "telephone_number": "314-469-0606",
            "fax_number": "314-469-3294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGL",
        "first_name": "LORIE",
        "middle_name": "LANETTE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "100391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4487786022",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.