Individual provider Active NPI

William R Hagan Jr., CRNA

  • Certified Registered Nurse Anesthetist
  • Asheville, NC
National Provider Identifier
1477650414
Registry record updated Dec 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
114654 Issued in NC
Practice address
76 Peachtree Road
Suite 300
Asheville, NC 28803-3505
Phone
(828) 274-3477
Fax
(828) 274-7407
NPI assigned
Sep 20, 2006
Last updated
Dec 11, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 114654 NC Primary

Addresses

Primary practice location

76 Peachtree Road
Suite 300
Asheville, NC 28803-3505

Mailing address

76 Peachtree Road
Suite 300
Asheville, NC 28803-3505
Phone (828) 274-3477

Other identifiers 8

IdentifierTypeStateIssuer
235113EOtherNCMEDICARE PTAN
2625250OtherNCPROVIDER NO CIGNA
8000180MedicaidNC
4300035342OtherNCHARRIS RR MCARE
114654OtherNCLICENSE NUMBER
430043596OtherNCSWAIN RR MCARE
260557OtherNCMEDICARE PTAN
8000315MedicaidNC

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

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386720000000",
    "number": "1477650414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 PEACHTREE ROAD",
            "address_2": "SUITE 300",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288033505",
            "telephone_number": "828-274-3477",
            "fax_number": "828-274-7407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 PEACHTREE ROAD",
            "address_2": "SUITE 300",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288033505",
            "telephone_number": "828-274-3477",
            "fax_number": "828-274-7407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGAN",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2013-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "114654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "235113E",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NO  CIGNA",
            "identifier": "2625250",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8000180",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARRIS RR MCARE",
            "identifier": "4300035342",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "114654",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SWAIN RR MCARE",
            "identifier": "430043596",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "260557",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8000315",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; 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.