Active NPI
Camille J Hagen, RD,LD
- Registered Dietitian
- Fosston, MN
National Provider Identifier
1992368294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 900 Hilligoss Blvd SE
Fosston, MN 56542-1542 - Phone
- (218) 435-1133
- NPI assigned
- Apr 22, 2019
- 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 | Primary |
Addresses
Primary practice location
900 Hilligoss Blvd SE
Fosston, MN 56542-1542
Mailing address
1702 University Dr S
Fargo, ND 58103-4940
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 |
|---|---|---|---|
| 4203 | MN | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555891200000",
"number": "1992368294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1702 UNIVERSITY DR S",
"city": "FARGO",
"state": "ND",
"postal_code": "581034940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 HILLIGOSS BLVD SE",
"city": "FOSSTON",
"state": "MN",
"postal_code": "565421542",
"telephone_number": "218-435-1133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAGEN",
"first_name": "CAMILLE",
"middle_name": "J",
"credential": "RD,LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-22",
"last_updated": "2019-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fosston, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.