Teri Ann Hagan, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME78785 Issued in FL

Practice address

13163 66TH Street North
Largo, FL 33773

Phone

(727) 228-7000

Fax

(727) 223-3614

NPI assigned

Jun 28, 2006

Last updated

Oct 10, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Dr. Teri Ann Hagan Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: teri.hagan.1@8042.direct.athenahealth.com

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.

• Privia Medical Group Florida, LLC

  • General Practice Physician
  • Indialantic, FL
  • NPI 1700649043
  NPD (past)

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1902834179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13163 66TH STREET NORTH",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "33773",
            "telephone_number": "727-228-7000",
            "fax_number": "727-223-3614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13163 66TH STREET NORTH",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "33773",
            "telephone_number": "727-228-7000",
            "fax_number": "727-223-3614"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3131 N McMullen Booth Rd",
            "address_purpose": "LOCATION",
            "city": "Clearwater",
            "state": "FL",
            "postal_code": "337612008",
            "country_code": "US",
            "telephone_number": "727-726-8871",
            "fax_number": "727-799-8605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGAN",
        "first_name": "TERI",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME78785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118777600",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020116000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00379115",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERI",
            "last_name": "HAGAN",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• GV Largo, Inc. (Grand Villa of Largo)
• Erin Nicole Gwyn, MS,MPH
• Kori Hacker, PTA
• Tracy Hacker, LCSW
• Samantha Hafner, LCSW
• Laura Elizabeth Hagerty, DDS
• Danielle Nicole Hahn, COTA
• Richard Joseph Hairston, MD
• Mohamad Imtiaz Hakim, MD
• Said Ismail Hakky, M.D., PH.D.

• Pediatrics Physician in Largo, FL
• Providers in Largo, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.