David J Hagedorn, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

03115 Issued in IA

Practice address

2101 Kimball Avenue
Suite 401
Waterloo, IA 50702

Phone

(319) 272-2002

Fax

(319) 272-2071

NPI assigned

Jan 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mr. David James Hagedorn Professional name

Medicare fee-for-service enrollment

Enrolled in IA

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, Doctor of Medicine

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.

• Grundy County Memorial Hospital

  • Critical Access Hospital
  • Grundy Center, IA
  • NPI 1821055989
  Medicare reassignment NPD
• Cedar Valley Hospice, Inc.

  • Community Based Hospice Care Agency
  • Waterloo, IA
  • NPI 1730304619

  Family Medicine

  NPD (past)
• Floyd County Memorial Hospital Commission

  • Critical Access Hospital
  • Charles City, IA
  • NPI 1265402390

  Family Medicine

  NPD (past)
• Iowa Physicians Clinic Medical Foundation

  • General Practice Physician
  • West Des Moines, IA
  • NPI 1366425274

  Family Medicine

  NPD (past)
• McFarland Clinic, PC

  • Physical Therapy Clinic/Center
  • Ames, IA
  • NPI 1427132711
  NPD (past)

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464825600000",
    "number": "1922078369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2880",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507042880",
            "telephone_number": "319-272-2002",
            "fax_number": "319-272-2071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 KIMBALL AVENUE",
            "address_2": "SUITE 401",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "50702",
            "telephone_number": "319-272-2002",
            "fax_number": "319-272-2071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEDORN",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2016-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "03115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0725283",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "HAGEDORN",
            "middle_name": "JAMES",
            "prefix": "MR.",
            "credential": "DO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Tracey Lynn Guthrie, CD(DONA)
• Kaylie Hackenmiller
• Sierra Hackman
• Geoffrey Kynan Hadlock, MD
• Katherine Marie Hadsall, DPM
• Nathan S Hahn, MD
• Kari Nicole Haislet, ARNP
• Brady Hakeman, D.C.
• Emily Halbur, O.D.
• Jennifer A Hall, PA-C

• Family Medicine Physician in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2016; 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.