NPIMap

Organization Active NPI

Jeff E Hagen MD

  • Gynecology Physician
  • Bastrop, TX
National Provider Identifier
1326322991
Registry record updated Sep 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
G3424 Issued in TX
Legal business name
JEFF E HAGEN MD
Practice address
301 Highway 71 W
Suite 111
Bastrop, TX 78602-4105
Phone
(512) 304-0318
Fax
(512) 308-9649
NPI assigned
Sep 30, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2011

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

Authorized official

Name
Dr. Jeff E Hagen, M.D.
Title
Owner
Phone
(512) 304-0318

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X G3424 TX Primary

Addresses

Primary practice location

301 Highway 71 W
Suite 111
Bastrop, TX 78602-4105

Mailing address

301 Highway 71 W
Suite 111
Bastrop, TX 78602-4105
Phone (512) 304-0318

Other identifiers 1

IdentifierTypeStateIssuer
041869104MedicaidTX

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1317340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317340800000",
    "number": "1326322991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 HIGHWAY 71 W",
            "address_2": "SUITE 111",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786024105",
            "telephone_number": "512-304-0318",
            "fax_number": "512-308-9649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HIGHWAY 71 W",
            "address_2": "SUITE 111",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786024105",
            "telephone_number": "512-304-0318",
            "fax_number": "512-308-9649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFF E HAGEN MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-30",
        "last_updated": "2011-09-30",
        "status": "A",
        "authorized_official_last_name": "HAGEN",
        "authorized_official_first_name": "JEFF",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-304-0318",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "TX",
            "license": "G3424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041869104",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bastrop, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; 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.