Individual provider Active NPI

Curt H Hagedorn, M.D.

  • Gastroenterology Physician
  • Salt Lake City, UT
National Provider Identifier
1487757399
Registry record updated Aug 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
6633685-8017 Issued in UT
Practice address
University of Utah School of Medicine
30 N 1900 E, Room 4R118
Salt Lake City, UT 84132-0001
Phone
(801) 581-7803
Fax
(801) 585-0187
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2009

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 04-30483 KS
Hepatology Physician 207RI0008X 04-30483 KS
Gastroenterology Physician 207RG0100X 6633685-8017 UT Primary
Hepatology Physician 207RI0008X 6633685-8018 UT

Addresses

Primary practice location

University of Utah School of Medicine
30 N 1900 E, Room 4R118
Salt Lake City, UT 84132-0001

Mailing address

University of Utah School of Medicine
30 N 1900 E, Room 4R118
Salt Lake City, UT 84132-0001
Phone (801) 581-7803

Other identifiers 4

IdentifierTypeStateIssuer
466570OtherKSFIRSTGUARD
200005150AMedicaidKS
208459008MedicaidMO
33271012OtherMOBCBS KC

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
04-30483KSMDGastroenterology Physician
6633685-8017UTMDGastroenterology Physician
6633685-8018UTMDHepatology Physician

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250553600000",
    "number": "1487757399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF UTAH SCHOOL OF MEDICINE",
            "address_2": "30 N 1900 E, ROOM 4R118",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-581-7803",
            "fax_number": "801-585-0187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF UTAH SCHOOL OF MEDICINE",
            "address_2": "30 N 1900 E, ROOM 4R118",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-581-7803",
            "fax_number": "801-585-0187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEDORN",
        "first_name": "CURT",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2009-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "KS",
            "license": "04-30483",
            "primary": false
        },
        {
            "code": "207RI0008X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hepatology",
            "state": "KS",
            "license": "04-30483",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "UT",
            "license": "6633685-8017",
            "primary": true
        },
        {
            "code": "207RI0008X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hepatology",
            "state": "UT",
            "license": "6633685-8018",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTGUARD",
            "identifier": "466570",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200005150A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208459008",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KC",
            "identifier": "33271012",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2009; 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.