Individual provider Active NPI

Kirsten Dlonra Hager

  • Surgery Physician
  • Grand Forks, ND
National Provider Identifier
1730819947
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
RL18553 Issued in ND
Practice address
1301 N Columbia Rd Stop 9037
Grand Forks, ND 58202-9037
Phone
(701) 777-3069
NPI assigned
Jun 13, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X RL18553 ND Primary

Addresses

Primary practice location

1301 N Columbia Rd Stop 9037
Grand Forks, ND 58202-9037

Mailing address

1301 N Columbia Rd Stop 9037
Grand Forks, ND 58202-9037
Phone (701) 777-3069

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20220921002668 ND Order and Referring Only - General SurgeryPractitioner - General Surgery 7719362102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1730819947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 N COLUMBIA RD STOP 9037",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582029037",
            "telephone_number": "701-777-3069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 N COLUMBIA RD STOP 9037",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582029037",
            "telephone_number": "701-777-3069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGER",
        "first_name": "KIRSTEN",
        "middle_name": "DLONRA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-13",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ND",
            "license": "RL18553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

Verify at the official NPI Registry.