Active NPI
Jennifer Marie Hagen, OTR
- Occupational Therapist
- Greenfield, WI
National Provider Identifier
1962254276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 3489-26
- Practice address
- 4110 W Barnard Ave
Greenfield, WI 53221-2549 - Phone
- (414) 217-1119
- NPI assigned
- Apr 2, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 3489-26 | WI | |
| Occupational Therapist | 225X00000X | 3489-26 | WI | Primary |
Addresses
Primary practice location
4110 W Barnard Ave
Greenfield, WI 53221-2549
Mailing address
4110 W Barnard Ave
Greenfield, WI 53221-2549
Phone (414) 217-1119
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3489-26 | WI | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712016000000",
"number": "1962254276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4110 W BARNARD AVE",
"city": "GREENFIELD",
"state": "WI",
"postal_code": "532212549",
"telephone_number": "414-217-1119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4110 W BARNARD AVE",
"city": "GREENFIELD",
"state": "WI",
"postal_code": "532212549",
"telephone_number": "414-217-1119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAGEN",
"first_name": "JENNIFER",
"middle_name": "MARIE",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-04-02",
"last_updated": "2024-04-02",
"certification_date": "2024-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "WI",
"license": "3489-26",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "3489-26",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.