NPIMap

Individual provider Active NPI

Christine Gagner

  • Audiologist
  • Waipahu, HI
National Provider Identifier
1346630209
Registry record updated Apr 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
60556649 Issued in WA
Practice address
94-1480 Moaniani St
Waipahu, HI 96797-4632
Phone
(808) 432-3100
NPI assigned
Jan 30, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 3033 CA
Audiologist 231H00000X 60556649 WA Primary

Addresses

Primary practice location

94-1480 Moaniani St
Waipahu, HI 96797-4632

Mailing address

9040A Jackson Ave
Tacoma, WA 98431-0001

Other practice location 1

9040A Jackson Ave
Tacoma, WA 98431-0001
Phone (253) 968-1110

Electronic endpoints 2

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
60556649WAMDAudiologist
3033CAMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1422576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1346630209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040A JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-1480 MOANIANI ST",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967974632",
            "telephone_number": "808-432-3100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9040A Jackson Ave",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984310001",
            "country_code": "US",
            "telephone_number": "253-968-1110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAGNER",
        "first_name": "CHRISTINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-30",
        "last_updated": "2021-04-19",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "3033",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WA",
            "license": "60556649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "qualitycare",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9040A Jackson Ave",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984310001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "94-1480 Moaniani St",
            "city": "Waipahu",
            "state": "HI",
            "country_code": "US",
            "postal_code": "967974632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waipahu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2021; 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.