Individual provider Active NPI

Lori Anne Hagaman, FNP-BC

  • Family Nurse Practitioner
  • South Hill, VA
National Provider Identifier
1699074567
Registry record updated Feb 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024169296 Issued in VA
Practice address
514 W Atlantic St
South Hill, VA 23970-1906
Phone
(434) 584-2000
Fax
(434) 447-2240
NPI assigned
Mar 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024169296 VA Primary

Addresses

Primary practice location

514 W Atlantic St
South Hill, VA 23970-1906

Mailing address

514 W Atlantic St
South Hill, VA 23970-1906
Phone (434) 584-2000

Other identifiers 2

IdentifierTypeStateIssuer
1699074567MedicaidVA
1699074567OtherVANPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20110523000518 VA Practitioner - Nurse Practitioner 9537345749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

514 W Atlantic St
South Hill, VA 23970-1906
Phone (434) 584-2025

518 W Atlantic St
South Hill, VA 23970-1906
Phone (434) 584-2025

8644 Sudley Rd
Suite 220
Manassas, VA 20110-4425
Phone (571) 366-8845

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024169296VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Apr 17, 2017 Accepting new patients
Privia Medical Group, LLC CurrentSince Apr 17, 2017 Accepting new patients
Medical Associates of Central Virginia, Inc. Past Accepting new patients

Locations

306 E 6th Ave
Kenbridge, VA 23944
Phone (434) 676-8021

8644 Sudley Rd
#220
Manassas, VA 20110

514 W Atlantic St
South Hill, VA 23970
Phone (434) 447-6969

518 W Atlantic St
South Hill, VA 23970
Phone (434) 447-4736

Interoperability endpoints

  • Direct secure messaging: lori.hagaman.1@8042.direct.athenahealth.com

Organizations & group practices 3

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": "1300320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486425600000",
    "number": "1699074567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 W ATLANTIC ST",
            "city": "SOUTH HILL",
            "state": "VA",
            "postal_code": "239701906",
            "telephone_number": "434-584-2000",
            "fax_number": "434-447-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 W ATLANTIC ST",
            "city": "SOUTH HILL",
            "state": "VA",
            "postal_code": "239701906",
            "telephone_number": "434-584-2000",
            "fax_number": "434-447-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGAMAN",
        "first_name": "LORI",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-17",
        "last_updated": "2017-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024169296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699074567",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1699074567",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Hill, VA

Sources for this page

Verify at the official NPI Registry.