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Deactivated NPI 1740247014 Deactivated / Inactive NPI Male Practitioner

Dr. Kenneth D Hagan , MD

Surgery • Jacksonville, FL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Kenneth Hagan has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 28, 2006
NPI Deactivation Date November 27, 2025
Total Practice Duration ~19 Years of Practice (2006 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. Kenneth Hagan, MD was a registered Surgery practicing in Jacksonville, FL. Throughout an active medical career spanning 19 years, Dr. Hagan provided care at the practice location at 3627 UNIVERSITY BLVD S until profile deactivation on 2025-11-27.

Practice Location & Contact Primary Location

Practice Address

3627 University Blvd S
Suite 700

Jacksonville, FL 322164230

Telephone 9043995678
Fax 9043998488
Associated Practice Facility / Clinic
🏢 First Coast Hospitalist P L Facility NPI 1700817327

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Jacksonville, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 22.4 Yrs
State Avg: 26.3 Yrs
Regional Practice Density
138 Specialists

Practicing in Jacksonville, FL (2030 Statewide)

Telehealth Adoption Rate
14.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License FL ME61915

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

9 Associated Practitioners
NPI 1386356509

Doctor of Nursing Practice, Advanced Practice Registered Nurse

Samantha Hanes , ARNP

Nurse Practitioner - Acute Care

NPI 1427340934

Advanced Registered Nurse Practitioner

NPI 1508026527

Doctor of Medicine (M.D.)

Lindsay Burden , ARNP

Nurse Practitioner

NPI 1578934873

Advanced Registered Nurse Practitioner

NPI 1710945944

Doctor of Medicine (M.D.)

Emma Atwell , PA-C

Physician Assistant

NPI 1821640624

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated November 27, 2025

Record deactivated on November 27, 2025

NPI Profile Active June 26, 2013

NPI status registered as active in NPPES database

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Updated Practice Location June 26, 2013

Registered at 3627 UNIVERSITY BLVD S, SUITE 700, JACKSONVILLE, FL 322164230 (Tel: 9043995678)

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Updated Business Mailing Address June 26, 2013

Registered at 11945 SAN JOSE BLVD, BLDG 300, JACKSONVILLE, FL 322231627 (Tel: 9043961725)

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Provider Name / Credentials Updated June 26, 2013

Recorded as KENNETH HAGAN, M. D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 26, 2013

Surgery (License #ME61915 in FL)

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Initial NPI Registration & Enumeration April 28, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1740247014
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 28, 2006
Last Update: June 26, 2013
Deactivation Date: November 27, 2025

Mailing Address

11945 San Jose Blvd, Bldg 300

Jacksonville, FL 322231627

Phone: 9043961725

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.