Individual provider Active NPI

Patricia Ann Hagmann, LPN

  • Licensed Practical Nurse
  • Ft Myers, FL
National Provider Identifier
1740464676
Registry record updated Dec 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN5150091 Issued in FL
Practice address
1705 Colonial Blvd
Pediatric Services of America
Ft Myers, FL 33908
Phone
(239) 939-3159
NPI assigned
Dec 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 1666641 NY
Licensed Practical Nurse 164W00000X PN5150091 FL Primary

Addresses

Primary practice location

1705 Colonial Blvd
Pediatric Services of America
Ft Myers, FL 33908

Mailing address

1705 Colonial Blvd
Pediatric Services of America
Ft Myers, FL 33908

Other names 1

  • Mrs. Patricia Ann McCormack Lee Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PN5150091FLMDLicensed Practical Nurse
1666641NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198713600000",
    "number": "1740464676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 COLONIAL BLVD",
            "address_2": "PEDIATRIC SERVICES OF AMERICA",
            "city": "FT MYERS",
            "state": "FL",
            "postal_code": "33908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 COLONIAL BLVD",
            "address_2": "PEDIATRIC SERVICES OF AMERICA",
            "city": "FT MYERS",
            "state": "FL",
            "postal_code": "33908",
            "telephone_number": "239-939-3159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGMANN",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-27",
        "last_updated": "2007-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "1666641",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5150091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "MCCORMACK LEE",
            "middle_name": "ANN",
            "prefix": "MRS.",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ft Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2007; 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.