Caroline Hagedorn, RN, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

7369181-4405 Issued in UT

Practice address

295 Chipeta Way
Salt Lake City, UT 84108-1287

Phone

(801) 587-7400

NPI assigned

Oct 5, 2009

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Interoperability endpoints

• Direct secure messaging: chagedorn50409@direct.med.utah.edu

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

{
    "created_epoch": "1254700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1629303839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 CHIPETA WAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081287",
            "telephone_number": "801-587-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 CHIPETA WAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081287",
            "telephone_number": "801-587-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEDORN",
        "first_name": "CAROLINE",
        "credential": "RN, PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-05",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "UT",
            "license": "7369181-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chagedorn50409@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "UNIVERSITY OF UTAH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• L Brent Hafen, MS
• Ta'Avili Hafoka
• Sydney Haga Harvey
• Mary Elizabeth Hagan, FNP
• Chadi Hage Chehade
• Curt H Hagedorn, M.D.
• Jean Morgan Hagedorn, NP-C
• William Hagee
• Synneva Hagen-Lillevik, MS, RD, CD
• Jolena Ann Hagen, PHARM.D.

• Pediatric Nurse Practitioner in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Pediatric Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.