DR. DAVID WILLIAM HAGEDORN (NPI# 1992906747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992906747 |
| Entity Type | Individual |
| Full Name | DR. DAVID WILLIAM HAGEDORN |
| Credential | PH.D. |
| Practice Address |
100 Brewster Blvd Naval Hospital - Family Medicine Camp Lejeune NC 28547 |
| Mailing Address |
200 Valencia Drive Suite 109 Jacksonville NC 28546-7807 |
| Practice Telephone | 9104508805 |
| Practice Fax Number | 9103531763 |
| Mailing Telephone | 9103531760 |
| Mailing Fax Number | 9103531763 |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2011-05-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 3745 | NC | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
PY00003898 | WA | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
1117 | SC | Behavioral Health & Social Service Providers |
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
32594 | TX | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528075058 | David Charles Hagedorn | Dentist | 340 Fairfield Ave, Bellevue, KY 41073-1010 | 2006-08-01 |
| 1346283892 | David K Hagedorn | Emergency Medicine | 3315 Mcintosh Cir, Joplin, MO 64804-3649 | 2006-06-13 |
| 1922078369 | David J Hagedorn | Family Medicine | 2101 Kimball Avenue, Suite 401, Waterloo, IA 50702 | 2006-01-26 |
| Street Address |
100 BREWSTER BLVD NAVAL HOSPITAL - FAMILY MEDICINE |
| City | CAMP LEJEUNE |
| State | NC |
| Zip Code | 28547 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588668982 | Pierce Overman | Family Medicine | 100 Brewster Blvd, Naval Hospital, Camp Lejeune, NC 28547-2538 | 2005-06-13 |
| 1275146417 | Kristi Lynn Dixon | Nurse Practitioner | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-08-27 |
| 1841802253 | Konstance Mackie | Nurse Practitioner | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-08-18 |
| 1003425117 | Jeremy Moore | Licensed Practical Nurse | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-07-24 |
| 1801404546 | Erika Merite Papenfuss | Nurse Anesthetist, Certified Registered | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-07-20 |
| 1306454244 | Devon Nicole Dan | Nurse Anesthetist, Certified Registered | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-07-16 |
| 1851918957 | Uriah Nmn Paul | Nurse Anesthetist, Certified Registered | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-07-06 |
| 1447876529 | Leslee Lynne Smith | Speech-Language Pathologist | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-06-24 |
| 1356965727 | Haleigh Leister | Specialist/Technologist | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-06-02 |
| 1407482045 | Shajaylyn Lee-combs | Student in an Organized Health Care Education/Training Program | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-03-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558906032 | Abigail Deemer | Physician Assistant | L Street, Bldg Hp-416, Camp Lejeune, NC 28547 | 2019-11-08 |
| 1407406267 | Michelle Ferricher | Nurse Practitioner | Naval Medical Center Pediatric Clinic, Nh-200 Recovery Way, Camp Lejeune, NC 28547 | 2019-09-13 |
| 1215595566 | Kayla L Torrez Chang | General Practice | Mcmh Fc 308, Hm Smith Boulevard, Camp Lejeune, NC 28547 | 2019-06-02 |
| 1699338442 | Amanda Leigh Jepsen | Military Health Care Provider | Naval Medical Center; 100 Brewster Blvd, Camp Lejeune, NC 28547 | 2019-04-17 |
| 1306336995 | Erik Reid King | Physician Assistant | F Street Bldg. Hp206, Camp Lejeune, NC 28547 | 2018-05-18 |
| 1114434032 | David John Mcdermott | Specialist/Technologist | Bldg. H1 Julian C Smith Rd., Camp Lejuene, NC 28547 | 2017-12-30 |
| 1235678434 | Nicolle Elizabeth Johnson | Occupational Therapist | 180 Hospital Corps Blvd., Camp Lejeune, NC 28547 | 2017-02-21 |
| 1427435585 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | Stone St. Extention, Bldg Nh200, Camp Lejeune, NC 28547 | 2015-04-28 |
| 1043634173 | Garrett Michael Wren | Obstetrics & Gynecology | Naval Medical Center, 100 Brewster Blvd, Camp Lejeune, NC 28547 | 2014-02-10 |
| 1245662436 | Samuel Maluil | Internal Medicine | Bldg 124 Wallace Creek, Camp Lejeunce, NC 28547 | 2013-07-30 |
| Find all providers in zip 28547 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689982274 | Kristin Lynn Landsinger | Clinical Neuropsychologist | Intrepid Spirit Concussion Recovery Center, 180 Hospital Corps Blvd., Camp Lejeune, NC 28547 | 2010-09-17 |
| 1720089295 | Margaret Anne Ackley | Clinical Neuropsychologist | Naval Medical Center, 100 Brewster Blvd, Camp Lejeune, NC 28547-2538 | 2005-08-09 |
| 1366557878 | Robin Henderson-logan | Clinical Neuropsychologist | 100 Brewster Blvd, Naval Hospital, Camp Lejeune, NC 28547-2538 | 2006-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467051458 | The Family Advocates | Clinical Neuropsychologist | 1201 Jade Glen Dr, Charlotte, NC 28262-1621 | 2020-10-20 |
| 1780118687 | Thomas Farrer | Clinical Neuropsychologist | 153 Carden Pl Apt C, Mebane, NC 27302-6080 | 2017-04-18 |
| 1891248795 | Anna Elizabeth Craig | Clinical Neuropsychologist | 20 W Colony Pl Ste 230, Durham, NC 27705-5577 | 2016-07-27 |
| 1063890614 | Michelle Jones Cueva | Clinical Neuropsychologist | 2218 Nelson Hwy, Suite 2, Chapel Hill, NC 27517-8923 | 2015-05-15 |
| 1992100465 | Griffin Pollock Sutton | Clinical Neuropsychologist | 19 S Hampstead Village Dr, Hampstead, NC 28443-3934 | 2014-10-27 |
| 1861818874 | Dr. Angela Houser-betti, Psyd, Pllc | Clinical Neuropsychologist | 4425 Randolph Rd Ste 208, Charlotte, NC 28211-2324 | 2014-03-14 |
| 1629499819 | Bay Area Psychology Associates | Clinical Neuropsychologist | 302 Woodberry Pl, Jacksonville, NC 28540-4264 | 2013-12-14 |
| 1790117679 | Kimberly Leon | Clinical Neuropsychologist | 1001 Blythe Blvd Ste 200d, Charlotte, NC 28203-6215 | 2013-08-02 |
| 1811260730 | Silber Psychological Services P.a. | Clinical Neuropsychologist | 1340 Se Maynard Rd, Suite 201, Cary, NC 27511-3632 | 2012-02-23 |
| 1881967222 | Taeh Allison Ward | Clinical Neuropsychologist | 45 Aviemore Dr, Pinehurst, NC 28374-9797 | 2012-02-15 |
| Find all providers with the same taxonomy | ||||
| City | CAMP LEJEUNE |
| Zip Code | 28547 |
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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.