Active NPI
Vicki Ann Gannon, M.A.,CCC-SLP
- Speech-Language Pathologist
- El Paso, TX
National Provider Identifier
1366768269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 10947
- Practice address
- 5005 N. Piedras St.
El Paso, TX 79920-5001 - Phone
- (915) 569-2073
- Fax
- (915) 569-1123
- NPI assigned
- Apr 16, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 10947 | TX | Primary |
Addresses
Primary practice location
5005 N. Piedras St.
El Paso, TX 79920-5001
Mailing address
10001 Goliad Dr.
El Paso, TX 79924-3716
Phone (915) 755-3213
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10947 | TX | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271376000000",
"number": "1366768269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10001 GOLIAD DR.",
"city": "EL PASO",
"state": "TX",
"postal_code": "799243716",
"telephone_number": "915-755-3213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5005 N. PIEDRAS ST.",
"city": "EL PASO",
"state": "TX",
"postal_code": "799205001",
"telephone_number": "915-569-2073",
"fax_number": "915-569-1123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANNON",
"first_name": "VICKI",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "M.A.,CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-04-16",
"last_updated": "2010-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "10947",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Paso, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.