Individual provider Active NPI

Judith Marie Hager, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Urbandale, IA
National Provider Identifier
1629475462
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
G157435 Issued in IA
Practice address
14321 Dellwood Dr
Urbandale, IA 50323-2096
Phone
(515) 321-4663
NPI assigned
Nov 21, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X G157435 IA Primary
Family Nurse Practitioner 363LF0000X A157005 IA

Addresses

Primary practice location

14321 Dellwood Dr
Urbandale, IA 50323-2096

Mailing address

14321 Dellwood Dr
Urbandale, IA 50323-2096
Phone (515) 321-4663

Other practice location 1

1223 Center St Ste 22
Des Moines, IA 50309-1016
Phone (515) 218-6125

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20200305001102 IA Practitioner - Nurse Practitioner 4789903808 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
A157005IAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Two Rivers Recovery, LLC CurrentSince Mar 1, 2020 Accepting new patients
Sondermind, P.a. Psychiatric/Mental Health CurrentSince Feb 1, 2026 Accepting new patients
First Step Wellness LLC CurrentSince Sep 6, 2020 Accepting new patients
Covert Action LLC Past Accepting new patients

Locations

699 Walnut St
Ste 4
Des Moines, IA 50309
Phone (515) 278-9920

801 E Douglas Ave
Fl 2
Wichita, KS 67202
Phone (316) 330-5353

Organizations & group practices 4

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": "1416528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580947200000",
    "number": "1629475462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14321 DELLWOOD DR",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503232096",
            "telephone_number": "515-321-4663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14321 DELLWOOD DR",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503232096",
            "telephone_number": "515-321-4663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1223 Center St Ste 22",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "503091016",
            "country_code": "US",
            "telephone_number": "515-218-6125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGER",
        "first_name": "JUDITH",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-21",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G157435",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A157005",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbandale, IA

Sources for this page

Verify at the official NPI Registry.