Angie Le'Alice Hagan, CPM, CNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

CNP-02963 Issued in NM

Practice address

1511 S Lime St
Deming, NM 88030-6207

Phone

(575) 538-2981

Fax

(855) 653-5023

NPI assigned

Dec 13, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Amador Health Center, Inc.Group PAC ID 0244501633, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Master of Science, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: angie.hagan.1@27572.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/20156/brand/1/csg/1/fhir/r4
• Direct secure messaging: angie.hagan.p1@direct.ahc.nextgenshare.com

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.

• Amador Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Las Cruces, NM
  • NPI 1700178167
  Medicare reassignment Care Compare group NPD
• Ben Archer Health Center

  • Federally Qualified Health Center (FQHC)
  • Truth Or Consequences, NM
  • NPI 1871528505
  Medicare reassignment NPD
• Silver Health Care PC

  • Internal Medicine Physician
  • Silver City, NM
  • NPI 1548291586
  Medicare reassignment NPD
• Amador Health Center, Inc.

  • Community/Retail Pharmacy
  • Las Cruces, NM
  • NPI 1407343445
  NPD
• Ben Archer Health Center

  • Federally Qualified Health Center (FQHC)
  • Deming, NM
  • NPI 1194443135
  NPD
• Ben Archer Health Center

  • Federally Qualified Health Center (FQHC)
  • Alamogordo, NM
  • NPI 1902831977
  NPD

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

{
    "created_epoch": "1260662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1629307194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 S LIME ST",
            "city": "DEMING",
            "state": "NM",
            "postal_code": "880306207",
            "telephone_number": "575-538-2981",
            "fax_number": "855-653-5171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 S LIME ST",
            "city": "DEMING",
            "state": "NM",
            "postal_code": "880306207",
            "telephone_number": "575-538-2981",
            "fax_number": "855-653-5023"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 S Gold Ave",
            "address_purpose": "LOCATION",
            "city": "Deming",
            "state": "NM",
            "postal_code": "880303731",
            "country_code": "US",
            "telephone_number": "575-680-3094",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3331 Del Rey Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "88012",
            "country_code": "US",
            "telephone_number": "575-373-1033",
            "fax_number": "575-267-1747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGAN",
        "first_name": "ANGIE",
        "middle_name": "LE'ALICE",
        "name_prefix": "Ms.",
        "credential": "CPM, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-13",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NM",
            "license": "CNP-02963",
            "primary": false
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "NM",
            "license": "02431R",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NM",
            "license": "CNP-02963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Ryan Gonzales
• Alba Cindy Gonzalez
• John Lynn Gordon, DDS
• Cheryl Granillo, CNP
• Luis D Gutierrez Pulido, DDS
• Alonni Rae Harrell
• Ryan Edward Harrington
• Renee Christine Heacox-Winborn, LISW
• Naomi Marisol Herrera
• Troy Craig Hill, LMFT

• Primary Care Nurse Practitioner in Deming, NM
• Providers in Deming, NM by specialty
• Primary Care Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; 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.
• 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.