Individual provider Active NPI

Tanya Hagen-Lee, CNP

  • Family Nurse Practitioner
  • Mitchell, SD
National Provider Identifier
1336711472
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CP000818 Issued in SD
Practice address
1900 Grassland Dr
Mitchell, SD 57301-6335
Phone
(605) 995-7000
NPI assigned
Jul 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CP000818 SD Primary

Addresses

Primary practice location

1900 Grassland Dr
Mitchell, SD 57301-6335

Mailing address

1900 Grassland Dr
Mitchell, SD 57301-6335
Phone (605) 995-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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

Enrollment IDStateProvider typePAC IDDetails
I20210813002741 SD Practitioner - Nurse Practitioner 9335543289 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rural Health Care IncGroup PAC ID 3476447541, 156 clinicians

Practice addresses (Care Compare)

1900 Grassland Dr
Suite 103
Mitchell, SD 57301-6386
Phone (605) 995-7000

609 Garfield Ave
Murdo, SD 57559-4100
Phone (605) 669-2121

Hospital & facility affiliations

  • Avera Queen of Peace Hospital, Mitchell, SD, CCN 431340

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CP000818SDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Avera Queen of Peace Current Accepting new patients
Rural Health Care, Inc CurrentSince Aug 4, 2021 Accepting new patients
Rural Health Care, Inc CurrentSince Aug 4, 2021 Accepting new patients
Avera Queen of Peace Current Accepting new patients
Avera Queen of Peace CurrentSince Aug 4, 2021 Accepting new patients
Avera Queen of Peace CurrentSince Aug 4, 2021 Accepting new patients
Rural Health Care, Inc. Current Accepting new patients
Avera Queen of Peace Past Accepting new patients

Locations

1900 Grassland Dr
Mitchell, SD 57301
Phone (605) 655-1220

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1626393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1336711472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 GRASSLAND DR",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573016335",
            "telephone_number": "605-995-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 GRASSLAND DR",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573016335",
            "telephone_number": "605-995-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEN-LEE",
        "first_name": "TANYA",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-16",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP000818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mitchell, SD

Sources for this page

Verify at the official NPI Registry.