Individual provider Active NPI

Jennifer Truong Hagg, PHARMD

  • Pharmacist
  • Glendale, AZ
National Provider Identifier
1467970251
Registry record updated Aug 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S022717 Issued in AZ
Practice address
6611 W Bell Rd
Glendale, AZ 85308-3607
Phone
(623) 334-2973
NPI assigned
Aug 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S022717 AZ Primary

Addresses

Primary practice location

6611 W Bell Rd
Glendale, AZ 85308-3607

Mailing address

20750 E Tara Springs Rd
Black Canyon City, AZ 85324-7204
Phone (417) 396-0418

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
S022717AZMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504137600000",
    "number": "1467970251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20750 E TARA SPRINGS RD",
            "city": "BLACK CANYON CITY",
            "state": "AZ",
            "postal_code": "853247204",
            "telephone_number": "417-396-0418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6611 W BELL RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853083607",
            "telephone_number": "623-334-2973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGG",
        "first_name": "JENNIFER",
        "middle_name": "TRUONG",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-31",
        "last_updated": "2017-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S022717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2017; 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.