Karissa M Hagen, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

24338 Issued in SC

Practice address

14 Medical Park Drive Suite 320
Columbia, SC 29203

Phone

(803) 434-6771

Fax

(803) 434-3955

NPI assigned

Mar 30, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Karissa M Noffke Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1417535717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-296-7320",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 MEDICAL PARK DRIVE SUITE 320",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "803-434-6771",
            "fax_number": "803-434-3955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "KARISSA",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-30",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "SC",
            "license": "24338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARISSA",
            "last_name": "NOFFKE",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• De'Onna Hadley
• Hadora Hospice of the Carolinas
• Jack Hampton Hadwin
• Randall Hadwin
• Brittanie Hagen, MD
• Clinton R Haggard, ATC, LAT, NREMT-B
• Deasia Hagler
• Leslie Hagood, SLP-A
• Hahn & Hahn Denistry Partnership
• Adam Hahn, DMD

• Acute Care Nurse Practitioner in Columbia, SC
• Providers in Columbia, SC by specialty
• Acute Care Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; 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.