Individual provider Active NPI

Michael Charles Hagan, D.C

  • Chiropractor
  • Bullhead City, AZ
National Provider Identifier
1619046166
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8940 Issued in AZ
Practice address
1738 Hway 95
Bullhead City, AZ 86442-6903
Phone
(928) 299-2260
Fax
(858) 298-3125
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 25448 CA
Chiropractor 111N00000X 8940 AZ Primary

Addresses

Primary practice location

1738 Hway 95
Bullhead City, AZ 86442-6903

Mailing address

1738 Hway 95
Bullhead City, AZ 86442-6903
Phone (928) 299-2260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201230002403 AZ Practitioner - Chiropractic 6103915798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1738 Hway
Suite 95
Bullhead City, AZ 86442-6903
Phone (928) 299-2260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8940AZMDPediatric Rehabilitation Medicine Physician
25448CAMDCertified Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hagan Chiropractic, Apc Chiropractor CurrentSince Jan 3, 2021 Accepting new patients

Locations

1738 Highway 95
Bullhead City, AZ 86442
Phone (858) 354-5022

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1619046166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1738 HWAY 95",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864426903",
            "telephone_number": "928-299-2260",
            "fax_number": "858-298-3125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1738 HWAY 95",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864426903",
            "telephone_number": "928-299-2260",
            "fax_number": "858-298-3125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGAN",
        "first_name": "MICHAEL",
        "middle_name": "CHARLES",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "25448",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "8940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bullhead City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.