Individual provider Active NPI

Daniel Kao-Lyn Dagenhart, DO

  • Emergency Medicine Physician
  • Orange Park, FL
National Provider Identifier
1457091399
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS22462 Issued in FL
Practice address
2001 Kingsley Ave
Orange Park, FL 32073-5148
Phone
(904) 639-2003
NPI assigned
Mar 30, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2024-02829 NC
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X OS22462 FL Primary

Addresses

Primary practice location

2001 Kingsley Ave
Orange Park, FL 32073-5148

Mailing address

12571 Costas Way
Jacksonville, FL 32246-0014
Phone (240) 285-6375

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250804001547 FL Practitioner - Emergency Medicine 3971011792 Reassigns benefits to 1 organization
I20250828003577 NC Practitioner - Emergency Medicine 3971011792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
William Carey University College of Osteopathic Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Emergency Services LLCGroup PAC ID 8628153087, 401 clinicians
Wake Emergency Physicians PAGroup PAC ID 9931002078, 269 clinicians

Practice addresses (Care Compare)

2001 Kingsley Ave
Orange Park, FL 32073-5148
Phone (904) 276-8500

3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS22462FLMDEmergency Medicine Physician
2024-02829NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Emergency Physicians PA Emergency Medicine CurrentSince Sep 1, 2025 Accepting new patients
Paragon Emergency Services LLC Emergency Medicine CurrentSince Aug 1, 2025 Accepting new patients
Wake Emergency Physicians PA Emergency Medicine CurrentSince Sep 1, 2025 Accepting new patients
Wake Emergency Physicians PA Emergency Medicine Past Accepting new patients

Locations

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

1451 El Camino Real
The Villages, FL 32159
Phone (352) 751-8000

210 Towne Village Dr
Cary, NC 27513
Phone (919) 348-4483

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

509 N Brightleaf Blvd
Smithfield, NC 27577
Phone (919) 934-8171

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 and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1457091399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12571 COSTAS WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322460014",
            "telephone_number": "240-285-6375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735148",
            "telephone_number": "904-639-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGENHART",
        "first_name": "DANIEL",
        "middle_name": "KAO-LYN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-30",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2024-02829",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS22462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.