Active NPI
Jody Ann Hagan, RD CDE
- Registered Dietitian
- Manchester, NH
National Provider Identifier
1962979401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 439
- Practice address
- 100 Hitchcock Way
Manchester, NH 03104-4125 - Phone
- (603) 645-6401
- Fax
- (603) 629-8654
- NPI assigned
- Nov 1, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 439 | NH | Primary |
Addresses
Primary practice location
100 Hitchcock Way
Manchester, NH 03104-4125
Mailing address
32 Clark Mill Rd
Weare, NH 03281-4608
Phone (603) 660-9652
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 |
|---|---|---|---|
| 439 | NH | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541030400000",
"number": "1962979401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32 CLARK MILL RD",
"city": "WEARE",
"state": "NH",
"postal_code": "032814608",
"telephone_number": "603-660-9652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 HITCHCOCK WAY",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031044125",
"telephone_number": "603-645-6401",
"fax_number": "603-629-8654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAGAN",
"first_name": "JODY",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "RD CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-01",
"last_updated": "2018-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NH",
"license": "439",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manchester, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.