Individual provider Active NPI

Patricia Dawn Hagler, CFM

  • Durable Medical Equipment & Medical Supplies
  • Midvale, UT
National Provider Identifier
1386758456
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
F42592 Issued in UT
Practice address
41 E 7720 S
Midvale, UT 84047-2650
Phone
(801) 566-3677
Fax
(801) 566-3677
NPI assigned
Aug 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X F42592 UT Primary

Addresses

Primary practice location

41 E 7720 S
Midvale, UT 84047-2650

Mailing address

41 E 7720 S
Midvale, UT 84047-2650
Phone (801) 566-3677

Other identifiers 3

IdentifierTypeStateIssuer
201801529001MedicaidUT
M100141OtherUTFACILITY ACCREDITED ABC
CFM00931OtherUTABC CERT. FITTER MASTECT.

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
F42592UTMDDurable Medical Equipment & Medical Supplies

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1386758456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 E 7720 S",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840472650",
            "telephone_number": "801-566-3677",
            "fax_number": "801-566-3677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 E 7720 S",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840472650",
            "telephone_number": "801-566-3677",
            "fax_number": "801-566-3677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGLER",
        "first_name": "PATRICIA",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "CFM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "UT",
            "license": "F42592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201801529001",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY ACCREDITED ABC",
            "identifier": "M100141",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ABC CERT. FITTER MASTECT.",
            "identifier": "CFM00931",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midvale, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.