Benjamin G Hagen, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2011014886 Issued in MO

Practice address

9331 Phoenix Village Pkwy
O Fallon, MO 63368-4281

Phone

(636) 561-4793

Fax

(636) 561-4811

NPI assigned

Jun 1, 2011

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Ati Holdings Missouri, LLC

  • Physical Therapist
  • Saint Louis, MO
  • NPI 1609277946
  NPD (past)
• Babar Enterprises LLC

  • Physical Therapist
  • Creve Coeur, MO
  • NPI 1033178827
  NPD (past)
• Babar Enterprises LLC

  • Physical Therapist
  • O Fallon, MO
  • NPI 1366607814
  NPD (past)
• FLS Physical Therapy Associates PC

  • Physical Therapy Clinic/Center
  • Columbia, IL
  • NPI 1669432522

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306886400000",
    "number": "1922392448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2454 W CLAY ST",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012548",
            "telephone_number": "636-916-4625",
            "fax_number": "636-916-4628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9331 PHOENIX VILLAGE PKWY",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633684281",
            "telephone_number": "636-561-4793",
            "fax_number": "636-561-4811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "BENJAMIN",
        "middle_name": "G",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-01",
        "last_updated": "2011-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2011014886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack Guo
• Sandra M Habermaas-Herold, CRNA
• Kimberly N Hackney, D.O.
• Emily Hadsall, DC
• Kaitlyn Hagee
• Janice E Hager-Klein, L.P.C.
• Lauren Hall, MOT/L
• Sarah Hall, ATC
• Jason Michael Hamed, DC
• Mitchell Hammack, DPT

• Physical Therapist in O Fallon, MO
• Providers in O Fallon, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; 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.