Adele Hagen, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AC001068 Issued in MD

Practice address

Medimmune Health and Wellness Center
1 Medimmune Way
Gaithersburg, MD 20878

Phone

(301) 398-6893

Fax

(301) 208-9861

NPI assigned

Sep 2, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Premise Health of Maryland Medical P C

  • Clinic/Center
  • Gaithersburg, MD
  • NPI 1649543513
  NPD (past)
• Premise Health of Connecticut Medical, P.C.

  • Primary Care Clinic/Center
  • Manassas, VA
  • NPI 1598054793
  NPD (past)

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

{
    "created_epoch": "1346544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1386993640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDIMMUNE WAY",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208782204",
            "telephone_number": "301-398-6893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDIMMUNE HEALTH AND WELLNESS CENTER",
            "address_2": "1 MEDIMMUNE WAY",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "20878",
            "telephone_number": "301-398-6893",
            "fax_number": "301-208-9861"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Physicians Weight Loss Centers",
            "address_2": "44031 Ashburn Shopping Plaza, #269",
            "address_purpose": "LOCATION",
            "city": "Ashburn",
            "state": "VA",
            "postal_code": "20147",
            "country_code": "US",
            "telephone_number": "703-729-7952",
            "fax_number": "703-729-1711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Micron Health Center",
            "address_2": "9600 Godwin Drive",
            "address_purpose": "LOCATION",
            "city": "Manassas",
            "state": "VA",
            "postal_code": "20110",
            "country_code": "US",
            "telephone_number": "703-396-1067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "ADELE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-02",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0106X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "MD",
            "license": "AC001068",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "AC001068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ilyssa Karen Haar, RN, IBCLC, BSN
• Sidra Habib
• Habibi & Mirdamadi D.D.S, PA.
• Amy Heather Hackman, LMSW
• Peter David Hadeed, D.D.S
• Hagerstown Recovery LLC
• Matty Page Haight
• Robyn S Haim, LMSW
• Sheherazade A Hakimzadeh, RBT
• Mikayla Haley

• Family Nurse Practitioner in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; 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.