Jody Lynn Hagen, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

2006010348 Issued in MO

Practice address

2115 S Fremont Ave Ste 3000
Springfield, MO 65804-2215

Phone

(417) 820-7708

NPI assigned

May 27, 2005

Sex

Female

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

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Mercy Clinic Springfield Communities

  • Family Medicine Physician
  • Springfield, MO
  • NPI 1245277631
  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  • Psychologist
  • Springfield, MO
  • NPI 1881636884
  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  • Rural Health Clinic/Center
  • Willow Springs, MO
  • NPI 1972771657
  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  • Family Medicine Physician
  • Hollister, MO
  • NPI 1053350454
  NPD
• Ozark Health Ventures, LLC

  • Rehabilitation Clinic/Center
  • Springfield, MO
  • NPI 1225113640
  NPD (past)
• Ozark Health Ventures, LLC

  • Psychologist
  • Springfield, MO
  • NPI 1427157999
  NPD (past)
• Senior Resolution Resources, Inc

  • Mental Health Counselor
  • Little Rock, AR
  • NPI 1760453914
  NPD (past)
• We Psychiatric Services PLLC

  • Psychologist
  • Little Rock, AR
  • NPI 1932174836
  NPD (past)

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1962405563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 S FREMONT AVE STE 3000",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042215",
            "telephone_number": "417-820-7708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 S FREMONT AVE STE 3000",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042215",
            "telephone_number": "417-820-7708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10515 W Markham St",
            "address_2": "Suite B1",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722052139",
            "country_code": "US",
            "telephone_number": "501-823-0589",
            "fax_number": "501-255-1446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "JODY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-27",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MO",
            "license": "2006010348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "5Y075",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leslie Allison Habermehl, BSW
• David Gilbert Hacker, DDS
• Alastair D Haddow, MD
• Benjamin Haden, M.D.
• Charles J. Haen, M.D.
• Sherrie Frances Hagenhoff, RD, LD, CDE
• Shelby Ross Hahn, MD
• Hamza Haider, MD
• Claire Elizabeth Haines
• Louis B. Hakan, D.O.

• Clinical Neuropsychologist in Springfield, MO
• Providers in Springfield, MO by specialty
• Clinical Neuropsychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; 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.
• 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.