Justin T Hagen, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2011012289 Issued in MO

Practice address

404 N Keene Street
Suite 404
Columbia, MO 65201

Phone

(573) 777-7627

Fax

(573) 777-4596

NPI assigned

Jul 28, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jhagen973139@directc.mercy.net

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.

• Mercy Clinic East Communities

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1851335228

  Pediatrics

  Medicare reassignment NPD
• Mercy Hospitals East Communities

  • Clinic/Center
  • Saint Louis, MO
  • NPI 1851431738
  Medicare reassignment NPD
• Mercy Hospitals East Communities

  • Land Ambulance
  • Saint Louis, MO
  • NPI 1881329902
  NPD
• Tiger Pediatrics LLC

  • Pediatrics Physician
  • Columbia, MO
  • NPI 1871872770
  NPD (past)

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312502400000",
    "number": "1811152044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 N KEENE STREET",
            "address_2": "SUITE 404",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "65201",
            "telephone_number": "573-777-7627",
            "fax_number": "573-777-4596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 N KEENE STREET",
            "address_2": "SUITE 404",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "65201",
            "telephone_number": "573-777-7627",
            "fax_number": "573-777-4596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "JUSTIN",
        "middle_name": "T",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-28",
        "last_updated": "2011-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "20080117891",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2011012289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Hadley
• Brandi J Haerer, NP
• Nicholas Hagan
• Kayla Renee Hagedorn, MOT, OTR/L
• Riley Rene Hagedorn
• Connor Hager
• Madeline Michelle Hager
• Michael P Hagerty, MD
• Lisa Lynn Haglund, LCSW
• Kristin E Hahn-Cover, M.D.

• Pediatrics Physician in Columbia, MO
• Providers in Columbia, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.