Lynelle Hagedorn

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

279A Issued in SD

Practice address

20440 476TH Ave
White, SD 57276-5914

Phone

(605) 629-8841

NPI assigned

Sep 5, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1409875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409875200000",
    "number": "1619378957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20440 476TH AVE",
            "city": "WHITE",
            "state": "SD",
            "postal_code": "572765914",
            "telephone_number": "605-629-8841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20440 476TH AVE",
            "city": "WHITE",
            "state": "SD",
            "postal_code": "572765914",
            "telephone_number": "605-629-8841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEDORN",
        "first_name": "LYNELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-05",
        "last_updated": "2014-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "SD",
            "license": "279A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• City of Brookings
• Deubrook Area School Dist 5 6
• Sherri Jo Gibson, CNP
• Hendricks Community Hospital Association
• Lori Sapp, PT
• Heather D Thompson, RN
• White Ambulance Service
• White Healthcare Center Inc

• Occupational Therapy Assistant in White, SD
• Providers in White, SD by specialty
• Occupational Therapy Assistant in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; 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.