Jill M. Hagenkord, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

24682 Issued in NE

Practice address

601 N 30TH St
Omaha, NE 68131-2137

Phone

(402) 449-4630

NPI assigned

Jun 16, 2008

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Creighton University

  • Allergy & Immunology (Internal Medicine) Physician
  • Omaha, NE
  • NPI 1295777225

  Anatomic Pathology & Clinical Pathology

  NPD (past)
• Creighton University

  • Physical Therapist
  • Omaha, NE
  • NPI 1780172304
  NPD (past)

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213574400000",
    "number": "1457511206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2159",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681032159",
            "telephone_number": "402-449-4630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N 30TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312137",
            "telephone_number": "402-449-4630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGENKORD",
        "first_name": "JILL",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-16",
        "last_updated": "2008-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NE",
            "license": "24682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47037658308",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla Marie Hagel
• Jeffrey Brooks Hagen, MD
• Kenneth J. Hagen Jr., DDS
• Marissa Grace Hagen, PLMHP
• Vicki L Hagen
• Lori Louise Hagensen, C.O.T.
• Michelle Kathleen Hagenson, RN, CWON
• Abby Layne Hager
• Kaitlyn Hager
• Randall Hager, LMHP, NCC

• Anatomic Pathology & Clinical Pathology Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Anatomic Pathology & Clinical Pathology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.