Active NPI
Alexandra Rupp Hagerman, MSN, APRN, FNP-C
- Family Nurse Practitioner
- Pontiac, MI
National Provider Identifier
1629569595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4704352134
- Practice address
- 461 W Huron St Ste 103
Pontiac, MI 48341-1601 - Phone
- (248) 724-7600
- NPI assigned
- May 25, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 112605 | CT | |
| Family Nurse Practitioner | 363LF0000X | 7630 | CT | |
| Family Nurse Practitioner | 363LF0000X | 4704352134 | MI | Primary |
Addresses
Primary practice location
461 W Huron St Ste 103
Pontiac, MI 48341-1601
Mailing address
1 Ford PL Ste 3a
Detroit, MI 48202-3450
Phone (313) 874-4806
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 112605 | CT | MD | Registered Nurse |
| 7630 | CT | MD | Family Nurse Practitioner |
| 4704352134 | MI | MD | Family Nurse Practitioner |
Interoperability endpoints
- ahagerman800719@direct.hfhs.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663891200000",
"number": "1629569595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 FORD PL STE 3A",
"city": "DETROIT",
"state": "MI",
"postal_code": "482023450",
"telephone_number": "313-874-4806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "461 W HURON ST STE 103",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483411601",
"telephone_number": "248-724-7600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAGERMAN",
"first_name": "ALEXANDRA",
"middle_name": "RUPP",
"name_prefix": "Mrs.",
"credential": "MSN, APRN, FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-25",
"last_updated": "2022-09-23",
"certification_date": "2022-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CT",
"license": "112605",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CT",
"license": "7630",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704352134",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pontiac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.