Individual provider Active NPI

Laura Daigle, MSN, APRN, CPNP-PC

  • Pediatric Nurse Practitioner
  • Cibolo, TX
National Provider Identifier
1417438425
Registry record updated Jun 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP139325 Issued in TX
Practice address
580 Cibolo Valley Dr Ste 221
Cibolo, TX 78108
Phone
(210) 314-1820
Fax
(830) 268-4713
NPI assigned
Aug 27, 2018
Last updated
Jun 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP139325 TX Primary
Registered Nurse 163W00000X 759168 TX

Addresses

Primary practice location

580 Cibolo Valley Dr Ste 221
Cibolo, TX 78108

Mailing address

580 Cibolo Valley Dr Ste 221
Cibolo, TX 78108-3834
Phone (210) 314-1820

Other practice location 1

580 Cibolo Valley Dr Ste 221
Cibolo, TX 78108
Phone (210) 314-1820

Other identifiers 1

IdentifierTypeStateIssuer
173913801MedicaidTX

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 Science - Nursing

State licenses

LicenseStateTypeSpecialty
759168TXMDRegistered Nurse
AP139325TXMDPediatric Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: ms.daigle@stcpc.opdirect.net

NPI Registry JSON

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561075200000",
    "number": "1417438425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 CIBOLO VALLEY DR STE 221",
            "city": "CIBOLO",
            "state": "TX",
            "postal_code": "781083834",
            "telephone_number": "210-314-1820",
            "fax_number": "830-268-4713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 CIBOLO VALLEY DR STE 221",
            "city": "CIBOLO",
            "state": "TX",
            "postal_code": "78108",
            "telephone_number": "210-314-1820",
            "fax_number": "830-268-4713"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "580 Cibolo Valley Dr Ste 221",
            "address_purpose": "LOCATION",
            "city": "Cibolo",
            "state": "TX",
            "postal_code": "78108",
            "country_code": "US",
            "telephone_number": "210-314-1820",
            "fax_number": "830-268-4713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAIGLE",
        "first_name": "LAURA",
        "credential": "MSN, APRN, CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-27",
        "last_updated": "2019-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP139325",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "759168",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173913801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cibolo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2019; 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.