Individual provider Active NPI

Angel Deanne McGahern, L.V.N.

  • Licensed Practical Nurse
  • Red Bluff, CA
National Provider Identifier
1356784920
Registry record updated Apr 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
272557 Issued in CA
Practice address
1860 Walnut St Ste B
Red Bluff, CA 96080-3611
Phone
(530) 527-8491
Fax
(530) 527-0204
NPI assigned
Apr 12, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 272557 CA Primary

Addresses

Primary practice location

1860 Walnut St Ste B
Red Bluff, CA 96080-3611

Mailing address

PO Box 400
Red Bluff, CA 96080-0400
Phone (530) 527-8491

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
272557CAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1365724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365724800000",
    "number": "1356784920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960800400",
            "telephone_number": "530-527-8491",
            "fax_number": "530-527-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 WALNUT ST STE B",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960803611",
            "telephone_number": "530-527-8491",
            "fax_number": "530-527-0204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGAHERN",
        "first_name": "ANGEL",
        "middle_name": "DEANNE",
        "credential": "L.V.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-12",
        "last_updated": "2013-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "CA",
            "license": "272557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bluff, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2013; 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.