Kelli L Hagen, DPT

Primary specialty

Neurology Physical TherapistTaxonomy code 2251N0400X

License

11-03982 Issued in KS

Practice address

8550 Marshall Dr
Ste 100
Lenexa, KS 66214-1505

Phone

(913) 894-1500

Fax

(913) 647-0295

NPI assigned

Jun 25, 2009

Last updated

Apr 26, 2016By 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

Other names 1

• Kelli L Wong Former name

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461628800000",
    "number": "1457589731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8550 MARSHALL DR",
            "address_2": "STE 100",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662141505",
            "telephone_number": "913-894-1500",
            "fax_number": "913-647-0295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8550 MARSHALL DR",
            "address_2": "STE 100",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662141505",
            "telephone_number": "913-894-1500",
            "fax_number": "913-647-0295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "KELLI",
        "middle_name": "L",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-25",
        "last_updated": "2016-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "KS",
            "license": "11-03982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUE SHEILD KC",
            "identifier": "42826014",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00975021",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLI",
            "last_name": "WONG",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gabriela Marie Gutierrez
• Michael Lee Haag, MD
• Christopher Martin Habben, PH.D.
• Bryan Hafits
• Daniel J Hageman, RDMS
• Sidney L Hagge-Cocke, DPT
• Vandana Halder, M.D.
• Trinity Michael Hall I
• Shannon Halvorsen, LMSW
• Omar B Hamid, PHARM D

• Neurology Physical Therapist in Lenexa, KS
• Providers in Lenexa, KS by specialty
• Neurology Physical Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.