Charlene Michelle Hagen, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

CNP-01673 Issued in NM

Practice address

622 W Maple St
Suite B
Farmington, NM 87401-6590

Phone

(505) 327-4867

Fax

(505) 327-5355

NPI assigned

Sep 22, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

San Juan Medical Group PCGroup PAC ID 2264468503, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Juan Regional Medical Center Inc Hospital, Farmington, NM, CCN 320005
• Mercy Regional Medical Center Hospital, Durango, CO, CCN 060013

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charlene.michelle.hagen.1@11485.direct.athenahealth.com

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.

• San Juan Medical Group PC

  • Family Medicine Physician
  • Farmington, NM
  • NPI 1609809235

  NM

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Aztec, NM
  • NPI 1770123382

  Hospital

  Care Compare affiliation
• San Juan Regional Medical Center Inc

  • Rehabilitation Hospital Unit
  • Farmington, NM
  • NPI 1326663592

  Hospital

  Care Compare affiliation
• San Juan Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Farmington, NM
  • NPI 1427058510

  Hospital

  Care Compare affiliation
• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Durango, CO
  • NPI 1083611644

  Hospital

  Care Compare affiliation
• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Durango, CO
  • NPI 1588204010

  Hospital

  Care Compare affiliation
• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Durango, CO
  • NPI 1679113104

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1285113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285113600000",
    "number": "1306154463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 W MAPLE ST",
            "address_2": "SUITE B",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874016590",
            "telephone_number": "505-327-4867",
            "fax_number": "505-327-5355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W MAPLE ST",
            "address_2": "SUITE B",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874016590",
            "telephone_number": "505-327-4867",
            "fax_number": "505-327-5355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "CHARLENE",
        "middle_name": "MICHELLE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-22",
        "last_updated": "2010-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "CNP-01673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Gurule
• Anysha Gustafson, FNP-C
• Karen Gustamantes
• Christopher A Gutierrez, MD
• Eric C Haag, DPM
• Gail L Hager
• Charlene Hahtatley, B.A., TLADAC
• Hairoun Home Health
• Joseph David Hakes, M.D.
• Lisa Marie Hall, RDH

• All providers in Farmington, NM
• Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.