Axogen Corporation

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

AXOGEN CORPORATION

Practice address

13859 Progress Blvd Ste 100
Alachua, FL 32615-9403

Phone

(386) 462-6800

Fax

(352) 462-6801

NPI assigned

Jan 28, 2011

Last updated

Jan 28, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Karen L Zaderej

Title

Chief Executive Officer

Phone

(386) 462-6818

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1296172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296172800000",
    "number": "1386940062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13859 PROGRESS BLVD STE 100",
            "city": "ALACHUA",
            "state": "FL",
            "postal_code": "326159403",
            "telephone_number": "386-462-6800",
            "fax_number": "352-462-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13859 PROGRESS BLVD STE 100",
            "city": "ALACHUA",
            "state": "FL",
            "postal_code": "326159403",
            "telephone_number": "386-462-6800",
            "fax_number": "352-462-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXOGEN CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-28",
        "last_updated": "2011-01-28",
        "status": "A",
        "authorized_official_last_name": "ZADEREJ",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "386-462-6818",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane L Amendola, LMT
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• Crystal Thompson Baumann, ARNP, FNP-C
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• James W Berk, M.D.
• Better Beginnings LLC
• Hemita Bhagwandass, PHARMD

• Non-Pharmacy Dispensing Site in Alachua, FL
• Providers in Alachua, FL by specialty
• Non-Pharmacy Dispensing Site in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.