Meredith Logan Hagstrom

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

5406 Wesley St
Greenville, TX 75402-6311

Phone

(903) 355-2110

NPI assigned

May 4, 2023

Last updated

May 4, 2023By 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

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DCS Medical PAGroup PAC ID 0042507600, 155 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• DCS Medical PA

  dba Integrity Urgent Care

  • Urgent Care Clinic/Center
  • Princeton, TX
  • NPI 1285082768
  Medicare reassignment Care Compare group NPD
• DCS Medical PA

  dba Integrity Urgent Care

  • Rural Health Clinic/Center
  • Bonham, TX
  • NPI 1063138741
  NPD

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

{
    "created_epoch": "1683158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1477242345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 COVINGTON CV",
            "city": "PRINCETON",
            "state": "TX",
            "postal_code": "754073024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5406 WESLEY ST",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754026311",
            "telephone_number": "903-355-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGSTROM",
        "first_name": "MEREDITH",
        "middle_name": "LOGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-04",
        "last_updated": "2023-05-04",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guthrie Medical Clinic Inc
• Maygan Gutierrez, OTR
• Pamela G Gwynn, LPC
• Gina Hackett, SLP
• Frankie Haddock, WHCNP
• Eithan David Haim, MD
• Norman J Hall, DC
• Shelley Hall, LPC
• Virginia Hall
• Syed Hamid

• Physician Assistant in Greenville, TX
• Providers in Greenville, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.