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NICOLE ANNETTE HAGEDORN D.O.
NPI 1619973997
Obstetrics & Gynecology in Jacksonville, NC

Active since June 22, 2005Opted out of Medicare · through Aug 19, 2028
2680 HENDERSON DR STE 5, JACKSONVILLE, NC 28546(910) 355-0442(910) 355-0443 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 21, 2022, Mar 17, 2018, Aug 25, 2017 (3 updates tracked since 2017).

About Nicole Annette Hagedorn D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE ANNETTE HAGEDORN D.O. (NPI 1619973997) is an individual obstetrics & gynecology provider in Jacksonville, North Carolina, licensed in North Carolina (78537) and active in the NPI registry since June 2005. She has opted out of Medicare through August 19, 2028 and remains eligible to order and refer and maintains a secondary practice location in Jacksonville.

NPPES Registry Identity

NPI1619973997
Entity TypeIndividualFemale
Primary Taxonomy207V00000X
Provider Legal NameNICOLE ANNETTE HAGEDORNCredential: D.O.
Location Address2680 HENDERSON DR STE 5Jacksonville, NC 28546-5297
Mailing Address2680 Henderson Dr Ste 5Jacksonville, NC 28546-5297 · (910) 355-0442
Phone(910) 355-0442
Fax(910) 355-0443
Sole ProprietorYes
Enumeration DateJune 22, 2005
Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration
✔ NPI 1619973997 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in NC · 78537
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
Also ListedClinical NeuropsychologistTaxonomy 103G00000X
2680 HENDERSON DR STE 5, Jacksonville, NC 28546
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Secondary Practice Location 1

Location 1200 Valencia Dr, Suite 109Jacksonville, NC 28546-6311 · Phone (580) 471-6664

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Nicole Annette Hagedorn D.o. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from August 19, 2020 through August 19, 2028.

Opt-Out Effective DateAugust 19, 2020
Opt-Out In Effect ThroughAugust 19, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28546 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$125.01 typical visit price
range $54.12 – $165.09
Typical copayment $31.25 (range $13.53 – $41.27)
Most-billed visit code 99204
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Hagedorn's NPI number?

The NPI number for Nicole Hagedorn is 1619973997. It was assigned to this individual provider in the NPPES registry on June 22, 2005.

Where is Nicole Hagedorn located?

Nicole Hagedorn practices at 2680 Henderson Dr Ste 5, Jacksonville, NC 28546. The listed phone number is (910) 355-0442.

What is Nicole Hagedorn's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Nicole Hagedorn enrolled in Medicare?

No. Nicole Hagedorn has opted out of Medicare through August 19, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Nicole Hagedorn was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.