Physician Compare National (NPI:1518049931)

HEALTHCARE PROVIDER: NATHAN B HAGEN MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1518049931
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2264478486
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050628001063
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HAGEN
	Individual professional last name
Provider First Name	NATHAN
	Individual professional first name
Provider Middle Name	BOYD
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	WEST VIRGINIA UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1970
	Individual professional's medical school graduation year
Primary Specialty	GENERAL PRACTICE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	115 S ST
	Group Practice or individual's line 1 address
City	MICHIGAN
	Group Practice or individual's city
State	ND
	Group Practice or individual's state
Zip Code	582590290
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7012592118
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	351308
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NELSON COUNTY HEALTH SYSTEM
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	350019
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ALTRU HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	350006
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	TRINITY HOSPITALS
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y