Brett Hagedoorn, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT10751 Issued in FL

Practice address

1075 Mason Ave
Daytona Beach, FL 32117-4611

Phone

(386) 255-4596

Fax

(386) 258-3561

NPI assigned

Mar 14, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564444800000",
    "number": "1720112758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 MASON AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321174611",
            "telephone_number": "386-255-4596",
            "fax_number": "386-258-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 MASON AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321174611",
            "telephone_number": "386-255-4596",
            "fax_number": "386-258-3561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1165 Dunlawton Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Port Orange",
            "state": "FL",
            "postal_code": "321272924",
            "country_code": "US",
            "telephone_number": "386-255-4596",
            "fax_number": "386-258-3561",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17 Old Kings Rd N Ste K",
            "address_purpose": "LOCATION",
            "city": "Palm Coast",
            "state": "FL",
            "postal_code": "321378283",
            "country_code": "US",
            "telephone_number": "386-255-4596",
            "fax_number": "386-258-3561",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1890 Lpga Blvd Ste 240",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "321177131",
            "country_code": "US",
            "telephone_number": "386-255-4596",
            "fax_number": "386-258-3561",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1175 Dunlawton Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Port Orange",
            "state": "FL",
            "postal_code": "321274741",
            "country_code": "US",
            "telephone_number": "386-255-4596",
            "fax_number": "386-258-3561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGEDOORN",
        "first_name": "BRETT",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2019-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "FL",
            "license": "PT10751",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT10751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aracelis Guzman
• Sabrina Guzsvany, FNP BC-C
• Mumeet H. Habeeb, MD
• Elizabeth C Hadaway, CRNA
• Linda Haddox, MD
• Phebe Nicole Hagins Wright, NP-C
• Sherida Ann Hahn, APRN, FNP-C
• Rose Haile
• Mylie Haire
• Taylor Haire, OTR/L

• Physical Therapist in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2019; 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.