Sophie K Hagedorn, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

4704391629 Issued in MI

Practice address

2136 W. M-32
Gaylord, MI 49735-9282

Phone

(989) 732-1791

Fax

(989) 732-7052

NPI assigned

Mar 29, 2023

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

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 and National Provider Directory roles.

• Northern Michigan Substance Abuse Services, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Gaylord, MI
  • NPI 1164641676
  NPD

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

{
    "created_epoch": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1801590286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2136 W. M-32",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497359282",
            "telephone_number": "989-732-1791",
            "fax_number": "989-732-7052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2136 W. M-32",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497359282",
            "telephone_number": "989-732-1791",
            "fax_number": "989-732-7052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEDORN",
        "first_name": "SOPHIE",
        "middle_name": "K",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-29",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704391629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Constance Guthrie, LMSW
• H2 Industries
• Louis S Habryl, DO
• Michael Louis Habryl, D.O
• Terry S Hadd, RPH
• Amy M Haggerty- Murphy, LMSW
• Robert L Halter, DO
• Michelle L Hamitlon
• Nick Andrew Hamlin, DPT
• Gene Lionel Hancock, RPH

• Registered Nurse in Gaylord, MI
• Providers in Gaylord, MI by specialty
• Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; 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.