Individual provider Active NPI

Jessica Ammons Hagemeier, M.D.

  • Pediatrics Physician
  • Bay Minette, AL
National Provider Identifier
1619903101
Registry record updated Mar 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
26341 Issued in AL
Practice address
2002 McMillan Ave
Bay Minette, AL 36507-4134
Phone
(251) 580-8475
NPI assigned
Jun 25, 2006
Last updated
Mar 17, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 26341 AL Primary

Addresses

Primary practice location

2002 McMillan Ave
Bay Minette, AL 36507-4134

Mailing address

2002 McMillan Ave
Bay Minette, AL 36507-4134
Phone (251) 580-8475

Other identifiers 1

IdentifierTypeStateIssuer
9938448MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100522000132 AL Practitioner - Pediatric Medicine 2264561638 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26341ALMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Imc - Hand Ave Family Practice P.C. PastSince Jan 23, 2010 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395014400000",
    "number": "1619903101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 MCMILLAN AVE",
            "city": "BAY MINETTE",
            "state": "AL",
            "postal_code": "365074134",
            "telephone_number": "251-580-8475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 MCMILLAN AVE",
            "city": "BAY MINETTE",
            "state": "AL",
            "postal_code": "365074134",
            "telephone_number": "251-580-8475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEMEIER",
        "first_name": "JESSICA",
        "middle_name": "AMMONS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2014-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "26341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9938448",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Minette, AL

Sources for this page

Verify at the official NPI Registry.