Individual provider Active NPI

Marcia K Hagen, APNP

  • Adult Health Nurse Practitioner
  • Tomah, WI
National Provider Identifier
1326284381
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
3576 Issued in WI
Practice address
501 Gopher Dr
Tomah, WI 54660-4513
Phone
(608) 372-2181
NPI assigned
Dec 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 3576 WI Primary

Addresses

Primary practice location

501 Gopher Dr
Tomah, WI 54660-4513

Mailing address

501 Gopher Dr
Tomah, WI 54660-4513
Phone (608) 372-2181

Other practice location 1

1836 South Ave
LA Crosse, WI 54601-5429
Phone (608) 782-7300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mhagen11413@direct.monroeclinic.org Direct Tomah Memorial Hospital Inc

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3576WIMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Clinic LTD Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1229904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1326284381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 GOPHER DR",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546604513",
            "telephone_number": "608-372-2181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 GOPHER DR",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546604513",
            "telephone_number": "608-372-2181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1836 South Ave",
            "address_purpose": "LOCATION",
            "city": "LA Crosse",
            "state": "WI",
            "postal_code": "546015429",
            "country_code": "US",
            "telephone_number": "608-782-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "MARCIA",
        "middle_name": "K",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-22",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WI",
            "license": "3576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mhagen11413@direct.monroeclinic.org",
            "affiliation": "Y",
            "affiliationName": "Tomah Memorial Hospital Inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mhagen11413@direct.monroeclinic.org",
            "address_1": "501 Gopher Dr",
            "city": "Tomah",
            "state": "WI",
            "country_code": "US",
            "postal_code": "546604513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tomah, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.