NPIMap

Individual provider Active NPI

John W Hagestrom, CRNA

  • Certified Registered Nurse Anesthetist
  • Sioux City, IA
National Provider Identifier
1497941140
Registry record updated Sep 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
101721 Issued in IA
Practice address
801 5TH St
Sioux City, IA 51101-1326
Phone
(712) 279-2505
NPI assigned
Sep 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2007

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 101721 IA Primary

Addresses

Primary practice location

801 5TH St
Sioux City, IA 51101-1326

Mailing address

233 W 1St St
Waconia, MN 55387-1302
Phone (952) 442-9770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, SD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070926000308 IA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2062506744 Reassigns benefits to 2 organizations
I20231214002442 SD Practitioner - Certified Registered Nurse Anesthetist (Crna) 2062506744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sacred Heart Health ServicesGroup PAC ID 6103729066, 151 clinicians

Practice addresses (Care Compare)

1000 W 4TH St
Suite 8
Yankton, SD 57078-3700

501 Summit St
Yankton, SD 57078-3855
Phone (605) 668-8795

Hospital & facility affiliations

  • Avera Sacred Heart Hospital Hospital, Yankton, SD, CCN 430012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101721IAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health Services CurrentSince Dec 1, 2023 Accepting new patients
Sacred Heart Health Services Current Accepting new patients
MHC Anesthesia Services CurrentSince May 14, 2007 Accepting new patients
Northwest Iowa Hospital Corporation CurrentSince Aug 1, 2025 Accepting new patients
Sacred Heart Health Services CurrentSince Dec 1, 2023 Accepting new patients

Locations

2720 Stone Park Blvd
Sioux City, IA 51104
Phone (712) 259-3000

801 5th St
Sioux City, IA 51101
Phone (712) 279-2010

400 10th St E
Waconia, MN 55387

501 Summit St
Yankton, SD 57078
Phone (605) 655-1201

Organizations & group practices 21

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.

View all 21

Hospital & facility affiliations 6

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": "1189987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189987200000",
    "number": "1497941140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 W 1ST ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871302",
            "telephone_number": "952-442-9770",
            "fax_number": "952-442-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 5TH ST",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511011326",
            "telephone_number": "712-279-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGESTROM",
        "first_name": "JOHN",
        "middle_name": "W",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-17",
        "last_updated": "2007-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "101721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.