Jennifer Jacquelyn Fagen, PT, MSPT, PRPC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTH3564 Issued in AL

Practice address

1717 6TH Ave South
SRC R385
Birmingham, AL 35249-3329

Phone

(205) 975-4922

Fax

(205) 934-7420

NPI assigned

May 12, 2006

Last updated

May 3, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Magic City Physical TherapyGroup PAC ID 1759792120, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Magic City Physical Therapy

  • Physical Therapist
  • Birmingham, AL
  • NPI 1912520115
  Medicare reassignment Care Compare group
• Gardendale Physician Associates, P.C.

  • Diagnostic Radiology Physician
  • Gardendale, AL
  • NPI 1558303842

  Physical Therapist

  NPD
• Simon-Williamson Clinic, P.C.

  • Internal Medicine Physician
  • Birmingham, AL
  • NPI 1497702344

  Physical Therapist

  NPD
• Benchmark Physical Therapy of Alabama, LLC

  • Physical Therapist
  • Moody, AL
  • NPI 1417386434
  NPD (past)
• Champion Rehab Resources, LLC

  • Physical Therapist
  • Vestavia, AL
  • NPI 1003437906
  NPD (past)

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1750332235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 19TH ST S",
            "address_2": "SRC R385",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352497201",
            "telephone_number": "205-975-4922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 6TH AVE SOUTH",
            "address_2": "SRC R385",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352493329",
            "telephone_number": "205-975-4922",
            "fax_number": "205-934-7420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGEN",
        "first_name": "JENNIFER",
        "middle_name": "JACQUELYN",
        "credential": "PT, MSPT, PRPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH3564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fagan LLC (Fagan Sports Medicine)
• Charles G. Fagan, M.D.
• Kimberly M Fagan, M.D.
• Shannon Travis Fagan, CRNP
• Iwona Jezak Fagbongbe
• Lauren Ashley Fagerstrom
• Farahnaz Fahimipour
• Jason Christopher Fain, M.D.
• Katie Fain, CRNP
• Braden Fairbanks, MD

• Physical Therapist in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Physical Therapist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.