Miesha Shelly Hagans, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP019984 Issued in PA

Practice address

1200 Old York Rd
Abington, PA 19001-3720

Phone

(215) 481-7158

NPI assigned

Apr 1, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mhagans2753348@carolinashealthcaresystem.direct-ci.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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  NC

  Medicare reassignment NPD
• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1003803032
  NPD (past)

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1679035539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5753 DUNLAP ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191313411",
            "telephone_number": "215-982-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 OLD YORK RD",
            "city": "ABINGTON",
            "state": "PA",
            "postal_code": "190013720",
            "telephone_number": "215-481-7158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGANS",
        "first_name": "MIESHA",
        "middle_name": "SHELLY",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP019984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dan Jonathan Gzesh, MD
• Enad Sami Yousef Haddad, M.D.
• Said Ziad Jamal Haddad, M.D.
• Zaid Haddadin, MD
• Kevin M Hagan, CRNP
• Hamzeh Moh'D Adeeb Halawani, M.D.
• Sarah Hall, M.D.
• Thomas Halloran Jr.
• Alycia Rasheen Ham, CRNP
• Mahsa Hamedi, MD

• Family Nurse Practitioner in Abington, PA
• Providers in Abington, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.