NPIMap

Individual provider Active NPI

John Gerald Hagan IV, DO

  • Family Medicine Physician
  • Southfield, MI
National Provider Identifier
1548790165
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101025515 Issued in MI
Practice address
16001 W. Nine Mile Road
Southfield, MI 48075
Phone
(248) 849-3000
Fax
(248) 849-5324
NPI assigned
Jun 15, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MI
Family Medicine Physician 207Q00000X 5101025515 MI Primary

Addresses

Primary practice location

16001 W. Nine Mile Road
Southfield, MI 48075

Mailing address

16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone (248) 849-3000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200608001398 MI Practitioner - Family Practice 3577984160 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Powerback Rehabilitation LLCGroup PAC ID 2365359932, shared by 106 NPIs, 600 clinicians
Mymichigan Medical GroupGroup PAC ID 4981501939, 174 clinicians

Practice addresses (Care Compare)

2325 Rockwell Dr
Midland, MI 48642-9325
Phone (989) 898-9664

555 W Wackerly St
Suite 600
Midland, MI 48640-4721
Phone (989) 488-5235

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101025515MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Alma Current Accepting new patients
Mymichigan Medical Center Alpena CurrentSince Nov 13, 2020 Accepting new patients
Mymichigan Medical Center Alma Family Medicine CurrentSince Apr 15, 2025 Accepting new patients
Mymichigan Medical Group CurrentSince Nov 13, 2020 Accepting new patients
Mymichigan Medical Group Family Medicine Current Accepting new patients

Locations

315 E Warwick Dr
Ste C
Alma, MI 48801
Phone (989) 463-9300

160 E Warwick Dr
Ste A
Alma, MI 48801
Phone (989) 466-7205

321 E Warwick Dr
Alma, MI 48801
Phone (989) 463-0957

602 Beech St
Ste 1100
Clare, MI 48617
Phone (989) 386-9911

5694 Midland Rd
Freeland, MI 48623
Phone (989) 695-2123

609 Quarter St
Gladwin, MI 48624
Phone (989) 246-6371

515 Quarter St
Gladwin, MI 48624
Phone (989) 246-6201

815 N Clare Ave
Harrison, MI 48625
Phone (989) 539-4096

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

2618 W Sugnet Rd
Midland, MI 48640
Phone (989) 633-5237

4500 N Campus Ridge Dr
Midland, MI 48640
Phone (989) 837-9250

555 W Wackerly St
Ste 600
Midland, MI 48640
Phone (989) 488-5235

555 W Wackerly St
Ste 1600
Midland, MI 48640
Phone (989) 374-0131

5785 E Broadway Rd
Mt Pleasant, MI 48858
Phone (989) 773-9421

Interoperability endpoints

  • Direct secure messaging: jhagan95766@mymichiganhealth.midirect.net

Organizations & group practices 6

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 7

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": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1548790165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16001 W 9 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754818",
            "telephone_number": "248-849-3000",
            "fax_number": "248-849-5324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16001 W. NINE MILE ROAD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48075",
            "telephone_number": "248-849-3000",
            "fax_number": "248-849-5324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGAN",
        "first_name": "JOHN",
        "middle_name": "GERALD",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-15",
        "last_updated": "2022-07-21",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101025515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.