Active NPI
Sue Ellen Hagie, NP
- Family Nurse Practitioner
- Denton, MD
National Provider Identifier
1477531077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R039951
- Practice address
- 301 Randolph St
Denton, MD 21629-1243 - Phone
- (410) 479-4306
- Fax
- (410) 479-1714
- NPI assigned
- Jan 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0024164940 | VA | |
| Family Nurse Practitioner | 363LF0000X | R039951 | MD | Primary |
Addresses
Primary practice location
301 Randolph St
Denton, MD 21629-1243
Mailing address
301 Randolph St
Denton, MD 21629-1243
Phone (410) 479-4306
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 521116591 | Other | MD | COVENTRY |
| 521116591 | Other | MD | TRICARE |
| T5880041 | Other | MD | CF BC/BS GRP/GHMSI/BL CHO |
| 521116591 | Other | MD | NCPPO |
| 89623401 | Other | MD | CAREFIRST BC/BS RENDERING |
| 206378 | Other | MD | PRIORITY PARTNERS |
| 521116591 | Other | MD | INFORMED |
| 521116591 | Other | MD | CIGNA |
| 784381000 | Medicaid | MD | |
| 521116591 | Other | MD | MARYLAND PHYSICIANS CARE |
Other names 1
- Ms. Sue Ellen Hagie
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R039951 | MD | MD | Family Nurse Practitioner |
| 0024164940 | VA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Ridge Health Center Inc | Past | Accepting new patients | |
| Blue Ridge Medical Center | Past | Accepting new patients | |
| Blue Ridge Health Center Inc | Past | Accepting new patients | |
| Blue Ridge Health Center Inc | Past | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/HHBDAA
Organizations & group practices 5
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.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
-
- Community/Retail Pharmacy
- Arrington, VA
- NPI 1083675862
-
- Federally Qualified Health Center (FQHC)
- Arrington, VA
- NPI 1336311323
-
- Federally Qualified Health Center (FQHC)
- Arrington, VA
- NPI 1962753145
-
- Pharmacy
- Arrington, VA
- NPI 1730559329
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214784000000",
"number": "1477531077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 RANDOLPH ST",
"city": "DENTON",
"state": "MD",
"postal_code": "216291243",
"telephone_number": "410-479-4306",
"fax_number": "410-479-1714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 RANDOLPH ST",
"city": "DENTON",
"state": "MD",
"postal_code": "216291243",
"telephone_number": "410-479-4306",
"fax_number": "410-479-1714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAGIE",
"first_name": "SUE",
"middle_name": "ELLEN",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-04",
"last_updated": "2008-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "VA",
"license": "0024164940",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MD",
"license": "R039951",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COVENTRY",
"identifier": "521116591",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "521116591",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CF BC/BS GRP/GHMSI/BL CHO",
"identifier": "T5880041",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPPO",
"identifier": "521116591",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST BC/BS RENDERING",
"identifier": "89623401",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIORITY PARTNERS",
"identifier": "206378",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INFORMED",
"identifier": "521116591",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "521116591",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "784381000",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MARYLAND PHYSICIANS CARE",
"identifier": "521116591",
"state": "MD"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SUE",
"last_name": "HAGIE",
"middle_name": "ELLEN",
"prefix": "MS.",
"credential": "FNP-C",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Denton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.