Callie Tucker Dagen, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD451215 Issued in PA

Practice address

169 Martin Ave
Ephrata, PA 17522-1724

Phone

(717) 733-0311

NPI assigned

May 4, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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 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.

• Ephrata Community Hospital

  • Emergency Medicine Physician
  • Ephrata, PA
  • NPI 1336286285
  Medicare reassignment NPD
• The Gettysburg Hospital

  • Emergency Medicine Physician
  • Gettysburg, PA
  • NPI 1366472706
  Medicare reassignment NPD
• The Gettysburg Hospital

  • Ambulatory Surgical Clinic/Center
  • Gettysburg, PA
  • NPI 1184882011
  NPD

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404172800000",
    "number": "1992097364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 MARTIN AVE",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175221724",
            "telephone_number": "717-733-0311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 MARTIN AVE",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175221724",
            "telephone_number": "717-733-0311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGEN",
        "first_name": "CALLIE",
        "middle_name": "TUCKER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-04",
        "last_updated": "2014-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD451215",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MT198941",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crossroads Surgery Center
• Crossroads Surgery Center, LLC
• Karen Ann Crouse, CNM
• Sarah E Crowther, DPT
• Rizalino S Cruz, MD
• Juliana McKenney Dailey
• Christy Lynn Daniels
• Richard A David, MD
• Brian David Debaun, MD
• Joseph G. Degenhard, MD

• Emergency Medicine Physician in Ephrata, PA
• Providers in Ephrata, PA by specialty
• Emergency Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2014; 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.