Individual provider Active NPI

Tiffany Hope Gagnon, LVN

  • Licensed Vocational Nurse
  • Laredo, TX
National Provider Identifier
1043962517
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
1049867 Issued in TX
Practice address
1605 Saldana Ave
Laredo, TX 78041-6220
Phone
(956) 724-3177
NPI assigned
Jan 25, 2022
Last updated
Jan 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 1049867 TX Primary

Addresses

Primary practice location

1605 Saldana Ave
Laredo, TX 78041-6220

Mailing address

628 Northstar Dr
Laredo, TX 78045-8044
Phone (956) 652-5233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1049867TXMDLicensed Vocational Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Serving Children and Adults in Need, Inc. CurrentSince Oct 15, 2023 Accepting new patients

Locations

1605 Saldana Ave
Laredo, TX 78041
Phone (956) 724-3177

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1043962517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 NORTHSTAR DR",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780458044",
            "telephone_number": "956-652-5233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 SALDANA AVE",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780416220",
            "telephone_number": "956-724-3177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "TIFFANY",
        "middle_name": "HOPE",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "1049867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.