Individual provider Active NPI

Terry M. Hagan, MD

  • Psychiatry Physician
  • Louisville, KY
National Provider Identifier
1689663718
Registry record updated Jul 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
21595 Issued in KY
Practice address
4010 Dupont Cir Ste 202
Louisville, KY 40207-4847
Phone
(502) 326-3011
Fax
(502) 324-4577
NPI assigned
Oct 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 21595 KY Primary

Addresses

Primary practice location

4010 Dupont Cir Ste 202
Louisville, KY 40207-4847

Mailing address

4010 Dupont Cir Ste 202
Louisville, KY 40207-4847
Phone (502) 326-3011

Other identifiers 1

IdentifierTypeStateIssuer
64215957MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050309000437 KY Practitioner - PsychiatryPractitioner - NeuropsychiatryPractitioner - Addiction MedicinePractitioner - NeurologyPractitioner - Geriatric Psychiatry 4486608718 Reassigns benefits to 1 organization
Practice locations: Louisville, KY

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Addiction Medicine, Geriatric Psychiatry, Neurology, Neuropsychiatry
Education
University of Louisville School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hagan Health LLCGroup PAC ID 5890129159, 8 clinicians

Practice addresses (Care Compare)

4010 Dupont Cir
Suite 202
Louisville, KY 40207-4847
Phone (502) 326-3011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21595KYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Eye Care PSC Current Accepting new patients
Hagan Health LLC Psychiatry CurrentSince Nov 15, 2019 Accepting new patients
Tabler Clinical Services, PSC Psychiatry PastSince Jun 1, 1992 Accepting new patients
Norton Enterprises, Inc. Past Accepting new patients
Community Medical Associates, Inc. Past Accepting new patients

Locations

4010 DuPont Cir
Ste 202
Louisville, KY 40207
Phone (502) 326-3011

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1689663718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 DUPONT CIR STE 202",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074847",
            "telephone_number": "502-326-3011",
            "fax_number": "502-324-4577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 DUPONT CIR STE 202",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074847",
            "telephone_number": "502-326-3011",
            "fax_number": "502-324-4577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGAN",
        "first_name": "TERRY",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "21595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64215957",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.