Individual provider Active NPI

Kent Hagan, D.C.

  • Chiropractor
  • Hayward, CA
National Provider Identifier
1841369220
Registry record updated Dec 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC19813 Issued in CA
Practice address
95 Jackson St
Hayward, CA 94544-1905
Phone
(510) 581-5813
Fax
(510) 581-7216
NPI assigned
Nov 7, 2006
Last updated
Dec 18, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC19813 CA Primary

Addresses

Primary practice location

95 Jackson St
Hayward, CA 94544-1905

Mailing address

95 Jackson St
Hayward, CA 94544-1905
Phone (510) 581-5813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100323000377 CA Practitioner - Chiropractic 1355486929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1988
Medicare assignment
May accept Medicare assignment
Group practices
Kent Hagan Chiropractic IncGroup PAC ID 8729123393, 3 clinicians

Practice addresses (Care Compare)

95 Jackson St
Hayward, CA 94544-1905
Phone (510) 581-5813

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC19813CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Kent Hagan Chiropractic, Inc Chiropractor CurrentSince Jan 29, 2010 Accepting new patients

Locations

95 Jackson St
Hayward, CA 94544
Phone (510) 581-5813

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261094400000",
    "number": "1841369220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 JACKSON ST",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945441905",
            "telephone_number": "510-581-5813",
            "fax_number": "510-581-7216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 JACKSON ST",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945441905",
            "telephone_number": "510-581-5813",
            "fax_number": "510-581-7216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGAN",
        "first_name": "KENT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2009-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC19813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2009; 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.