Katie L. Hageman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA0000001547 Issued in TN

Practice address

123 Fox Rd
Knoxville, TN 37922-3369

Phone

(865) 690-9467

Fax

(865) 342-5857

NPI assigned

Feb 20, 2008

Last updated

Aug 4, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• East Tennessee Dermatology Group, PC

  • Dermatology Physician
  • Alcoa, TN
  • NPI 1891050407
  NPD (past)
• Southern Dermatology, P.a.

  • Specialist
  • Raleigh, NC
  • NPI 1568415586
  NPD (past)

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1427226778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 FOX RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223369",
            "telephone_number": "865-690-9467",
            "fax_number": "865-342-5857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 FOX RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223369",
            "telephone_number": "865-690-9467",
            "fax_number": "865-342-5857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEMAN",
        "first_name": "KATIE",
        "middle_name": "L.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-20",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA0000001547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1505903",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA-C LICENSE",
            "identifier": "PA0000001547",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria Marie Haddad
• Tylen K Haderlie, DDS
• Alexandria Hadley, RD
• Kendra Paige Hadley
• Sarah Hagar, PA-C
• Gary Hagerman, DC
• Christopher J Haggerty, M.D.
• Amanda Elaine Hagie, OTR/L
• Gregory William Hagopian, CRNA
• Lori Rorrer Hagopian, FNP

• Physician Assistant in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.