Active NPI
John William Daigle, M.D.
- Surgery Physician
- Fort Sam Houston, TX
National Provider Identifier
1184077869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- U5675
- Practice address
- 3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504 - Phone
- (210) 539-9582
- NPI assigned
- Jul 19, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | U5675 | TX | Primary |
Addresses
Primary practice location
3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Mailing address
3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Other practice location 1
300 East Hospital Road
Transitional Program, Dwight D. Eisenhower AMC
Fort Gordon, GA 30905-5650
Phone (706) 787-4657
Other practice location 2
1120 15th St
Augusta, GA 30912-0004
Phone (706) 721-2503
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181220000487 | GA | Order and Referring Only - General Surgery | 6901141936 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| U5675 | TX | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691107200000",
"number": "1184077869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3551 ROGER BROOKE DR",
"city": "FORT SAM HOUSTON",
"state": "TX",
"postal_code": "782344504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3551 ROGER BROOKE DR",
"city": "FORT SAM HOUSTON",
"state": "TX",
"postal_code": "782344504",
"telephone_number": "210-539-9582"
}
],
"practiceLocations": [
{
"address_1": "300 East Hospital Road",
"address_2": "Transitional Program, Dwight D. Eisenhower AMC",
"address_purpose": "LOCATION",
"city": "Fort Gordon",
"state": "GA",
"postal_code": "309055650",
"country_code": "US",
"telephone_number": "706-787-4657",
"fax_number": "706-787-1745",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1120 15th St",
"address_purpose": "LOCATION",
"city": "Augusta",
"state": "GA",
"postal_code": "309120004",
"country_code": "US",
"telephone_number": "706-721-2503",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAIGLE",
"first_name": "JOHN",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-19",
"last_updated": "2023-08-04",
"certification_date": "2023-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "TX",
"license": "U5675",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Sam Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.