DR. JODY LYNN HAGEN (PHD) – Clinical Neuropsychologist, NPI 1962405563
Clinical Neuropsychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
118 CLINICAL PSYCHOLOGIST in AR
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Provider Addresses for DR. JODY LYNN HAGEN (PHD)
PO BOX 206
MABELVALE, AR 721030206
Phone: (501) 823-0589
Fax: (501) 255-1446
Type: Mailing
West Markham Street, Little Rock, Pulaski County, Arkansas, 72211, United States
SUITE B1
LITTLE ROCK, AR 722052139
Phone: (501) 823-0589
Fax: (501) 255-1446
Type: Location
10515 W Markham St
Suite B1
Little Rock, AR 722052139
Phone: (501) 823-0589
Fax: (501) 255-1446
Type: Location
2115 S FREMONT AVE STE 3000
SPRINGFIELD, MO 658042215
Phone: (417) 820-7708
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2006-11-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20061122000196 | I | Clinical Psychologist | MO | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 72103)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MO | |
| - | MO | |
| - | MO | |
| - | MO | |
| Clinical Psychologist | MO | |
| Nurse Practitioner | MO | |
| - | MO | |
| U R O L O G Y | MO | |
| P O D I A T R Y | MO | |
| - | KS |
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