Individual provider Active NPI

Renee Ann Hagemann, P.T.

  • Physical Therapist
  • Kearney, NE
National Provider Identifier
1710258694
Registry record updated Feb 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2025 Issued in NE
Practice address
3219 Central Ave
Ste 105
Kearney, NE 68847-2949
Phone
(308) 865-7182
Fax
(308) 865-2881
NPI assigned
Jan 24, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2025 NE Primary

Addresses

Primary practice location

3219 Central Ave
Ste 105
Kearney, NE 68847-2949

Mailing address

PO Box 5285
Grand Island, NE 68802-5285
Phone (308) 865-7182

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

State licenses

LicenseStateTypeSpecialty
2025NEMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1327363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1710258694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5285",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688025285",
            "telephone_number": "308-865-7182",
            "fax_number": "308-382-3241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3219 CENTRAL AVE",
            "address_2": "STE 105",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688472949",
            "telephone_number": "308-865-7182",
            "fax_number": "308-865-2881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEMANN",
        "first_name": "RENEE",
        "middle_name": "ANN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-24",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "2025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.

Verify at the official NPI Registry.