JASON R HAGERTY (NPI# 1073928537) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073928537 |
| Entity Type | Individual |
| Full Name | JASON R HAGERTY |
| Credential | NP-C |
| Practice Address |
2424 Manatee Ave W Ste 100 Bradenton FL 34205-4954 |
| Mailing Address |
10051 5th St N Ste 200 St Petersburg FL 33702-2211 |
| Practice Telephone | 9418477920 |
| Practice Fax Number | 9417572291 |
| Mailing Telephone | 7278240780 |
| Mailing Fax Number | 7275686011 |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2020-08-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
COA.16064-NP | OH | Ambulatory Health Care Facilities |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
ARNP9396930 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
COA.16064-NP | OH | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 014664800 | 05 |
| Street Address |
2424 MANATEE AVE W STE 100 |
| City | BRADENTON |
| State | FL |
| Zip Code | 34205-4954 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417034810 | Babette M Pachence | Internal Medicine | 2424 Manatee Ave W Ste 100, Bradenton, FL 34205-4954 | 2006-11-01 |
| 1720222086 | Navindra Ramdath | Family Medicine | 2424 Manatee Ave W Ste 100, Bradenton, FL 34205-4954 | 2009-04-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649811506 | Fenix Drug Store, LLC | Pharmacy | 527 13th St W, Bradenton, FL 34205 | 2019-10-02 |
| 1326534702 | Elaine Benitez Vazquez | Developmental Therapist | 3800 Lake Bayshore Dr Apt 513, Bradenton, FL 34205 | 2018-07-09 |
| 1437519402 | Kenneth G Bannister | Massage Therapist | 302 26th Avenue East, Apt 101, Bradenton, FL 34205 | 2016-03-03 |
| 1780028415 | Nic 4 Summerfield Leasing LLC | Assisted Living Facility | 3409 26th St. W., Bradenton, FL 34205 | 2013-04-24 |
| 1275803017 | Jennifer Geanne Washington | Massage Therapist | 1901 9th Ave W, Bradenton, FL 34205 | 2012-01-11 |
| 1629352745 | Susan K Stone | Acupuncturist | 2620 Manatee Avenue W., Suite C, Bradenton, FL 34205 | 2011-10-07 |
| 1588957609 | Palma Sola Therapies LLC | Physical Medicine & Rehabilitation | 515 36th St., Suite D, Bradenton, FL 34205 | 2011-05-23 |
| 1023254836 | Halle Kranz | Counselor | 239 301 Blvd W, Bradenton, FL 34205 | 2008-12-29 |
| 1235389537 | Aisha Mohsin Malik | Psychiatry & Neurology | 200 3rd Avenue West, Suite 110, Bradenton, FL 34205 | 2008-09-23 |
| 1689895146 | Brenda Marie Wilson | Counselor | Manatee Service Center, 600 301 Blvd - Suite 144, Bradenton, FL 34205 | 2007-05-01 |
| Find all providers in zip 34205 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881208494 | Abby Elizabeth Crews | Nurse Practitioner | 7534, Divot Loop, Bradenton, FL 34202 | 2020-09-01 |
| 1568002459 | South Florida Injury and Convenient Care | Nurse Practitioner | 2601 Manatee Ave W Ste E, Bradenton, FL 34205-4942 | 2020-01-09 |
| 1033758917 | Brooke Ariel Talbert | Nurse Practitioner | 1803 5th St W, Bradenton, FL 34205-8303 | 2019-12-25 |
| 1912550476 | Vilma Rodriguez | Nurse Practitioner | 1200 37th Ave E, Bradenton, FL 34208-4553 | 2019-07-23 |
| 1366008930 | Mary Janell Hostetler | Nurse Practitioner | 11611 Brookside Dr, Bradenton, FL 34211-4525 | 2019-05-19 |
| 1144886177 | Jewel Tartt | Nurse Practitioner | 1001 13th Avenue East, Medical Department, Bradenton, FL 34208-3420 | 2019-05-15 |
| 1336607522 | Katrina Onyx Wilson | Nurse Practitioner | 304 74th Street Ct Nw, Bradenton, FL 34209-2220 | 2019-03-06 |
| 1184193047 | Mary Kathleen Dufek | Nurse Practitioner | 8610 State Road 70 E, Bradenton, FL 34202-3785 | 2018-11-20 |
| 1255840922 | Megan Fallon | Nurse Practitioner | 250 2nd St E Ste 3b, Bradenton, FL 34208-1027 | 2017-09-26 |
| 1639604556 | Jodie Lynn Dodge | Nurse Practitioner | 8614 State Road 70 E Ste 200, Bradenton, FL 34202-3710 | 2017-04-28 |
| Find all providers in BRADENTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.