NPIMap

Organization Active NPI

Tyler K. Hagan, DPM, PLLC

  • Foot & Ankle Surgery Podiatrist
  • New Bern, NC
National Provider Identifier
1720489818
Registry record updated Dec 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
617 Issued in NC
Legal business name
TYLER K. HAGAN, DPM, PLLC
Practice address
612A McCarthy Blvd
New Bern, NC 28562-5231
Phone
(252) 633-3400
Fax
(252) 633-9338
NPI assigned
Sep 9, 2014
Last updated
Dec 4, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2014

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

Authorized official

Name
Tyler K Hagan, DPMNPI 1588955231
Title
Sole Member
Phone
(252) 633-3400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 617 NC
Foot & Ankle Surgery Podiatrist 213ES0103X 617 NC Primary
Foot Surgery Podiatrist 213ES0131X 617 NC

Addresses

Primary practice location

612A McCarthy Blvd
New Bern, NC 28562-5231

Mailing address

612A McCarthy Blvd
New Bern, NC 28562-5231
Phone (252) 633-3400

Other identifiers 1

IdentifierTypeStateIssuer
1588955231OtherNCINDIVIDUAL NPI

National Provider Directory

National Provider Directory

Locations

612 McCarthy Blvd
#A
New Bern, NC 28562
Phone (252) 633-3400

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1410220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417651200000",
    "number": "1720489818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612A MCCARTHY BLVD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285625231",
            "telephone_number": "252-633-3400",
            "fax_number": "252-633-9338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612A MCCARTHY BLVD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285625231",
            "telephone_number": "252-633-3400",
            "fax_number": "252-633-9338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYLER K. HAGAN, DPM, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-09",
        "last_updated": "2014-12-04",
        "status": "A",
        "authorized_official_last_name": "HAGAN",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "252-633-3400",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NC",
            "license": "617",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NC",
            "license": "617",
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NC",
            "license": "617",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1588955231",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bern, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; 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.