Individual provider Active NPI

Kristen Marie Hager, D.C.

  • Chiropractor
  • Shakopee, MN
National Provider Identifier
1396927315
Registry record updated Mar 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5024 Issued in MN
Practice address
4201 Dean Lakes Blvd Ste 140
Shakopee, MN 55379-2850
Phone
(952) 402-9355
NPI assigned
Nov 30, 2007
Last updated
Mar 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5024 MN Primary

Addresses

Primary practice location

4201 Dean Lakes Blvd Ste 140
Shakopee, MN 55379-2850

Mailing address

2124 Winterberry LN
Shakopee, MN 55379-5901
Phone (612) 701-8803

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
5024MNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Healthcare Services Golden Valley PA Chiropractor PastSince Apr 1, 2009 Accepting new patients
Eagle Creek Chiropractic Past Accepting new patients
Hartley Chiropractic Wellness Center, LLC Chiropractor Past Accepting new patients
Care Chiropractic Body Wellness Center, LLC Chiropractor Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553126400000",
    "number": "1396927315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 WINTERBERRY LN",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553795901",
            "telephone_number": "612-701-8803",
            "fax_number": "612-701-8803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 DEAN LAKES BLVD STE 140",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553792850",
            "telephone_number": "952-402-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGER",
        "first_name": "KRISTEN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-30",
        "last_updated": "2019-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shakopee, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2019; 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.