Individual provider Active NPI

Kenneth J Hager, MD

  • Diagnostic Radiology Physician
  • Jasper, AL
National Provider Identifier
1477538163
Registry record updated Dec 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
000022796 Issued in AL
Practice address
3400 Highway 78 E
Jasper, AL 35501-8950
Phone
(205) 221-3523
Fax
(205) 221-3560
NPI assigned
Dec 14, 2005
Last updated
Dec 30, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 000022796 AL Primary

Addresses

Primary practice location

3400 Highway 78 E
Jasper, AL 35501-8950

Mailing address

2000A Southbridge Pkwy
Ste 300
Birmingham, AL 35209-7718
Phone (205) 871-4274

Other identifiers 3

IdentifierTypeStateIssuer
511-52186OtherALBLUE CROSS
166634MedicaidAL
P01409686OtherALRRMC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070725000165 AL Practitioner - Diagnostic Radiology 4981705662 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Alabama School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ecm Health Group LLCGroup PAC ID 9436395225, 139 clinicians

Practice addresses (Care Compare)

201 Avalon Ave
Muscle Shoals, AL 35661-2805
Phone (256) 712-3175

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Marion Regional Medical Center, Inc. CurrentSince Sep 18, 2000 Accepting new patients
Marion Regional Medical Center, Inc. Current Accepting new patients
Marion Regional Medical Center, Inc CurrentSince Sep 18, 2000 Accepting new patients

Locations

1256 Military St S
Hamilton, AL 35570
Phone (205) 921-6200

1336 Military St S
Hamilton, AL 35570
Phone (205) 921-0521

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451433600000",
    "number": "1477538163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000A SOUTHBRIDGE PKWY",
            "address_2": "STE 300",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352097718",
            "telephone_number": "205-871-4274",
            "fax_number": "205-871-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 HIGHWAY 78 E",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355018950",
            "telephone_number": "205-221-3523",
            "fax_number": "205-221-3560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGER",
        "first_name": "KENNETH",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2015-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AL",
            "license": "000022796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "511-52186",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166634",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "P01409686",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, AL

Sources for this page

Verify at the official NPI Registry.