Tyler G Gagon, DC, AC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

9341 Issued in AZ

Practice address

3088 N Robert Rd
Prescott Valley, AZ 86314-8653

Phone

(928) 775-0522

Fax

(928) 775-5922

NPI assigned

May 21, 2018

Last updated

Oct 8, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 2018

Medicare assignment

May accept Medicare assignment

Group practices

Prescott Valley Chiropractic LLCGroup PAC ID 7911981295, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Prescott Valley Chiropractic LLC

  dba Prescott Valley Chiropractic

  • Chiropractor
  • Prescott Valley, AZ
  • NPI 1366637746
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1487145934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3088 N ROBERT RD",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863148653",
            "telephone_number": "928-775-0522",
            "fax_number": "928-775-5922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3088 N ROBERT RD",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863148653",
            "telephone_number": "928-775-0522",
            "fax_number": "928-775-5922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGON",
        "first_name": "TYLER",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "DC, AC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-21",
        "last_updated": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "108041421202",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "9341",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "AZ",
            "license": "0631",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maia Fruchthandler
• Gary Fulkerson, P.A.
• Marissa May Fuller
• Melanie Nicole Fuller
• John Paul Futral, D.C.
• John Joseph Galasso, DACHM
• Jared Gamble, OTR/L
• Ronda Rae Garber, RN
• Emily Rose Garcia-Wood, FNP-BC
• Katherine Rose Garcia, MS CCC SLP

• Chiropractor in Prescott Valley, AZ
• Providers in Prescott Valley, AZ by specialty
• Chiropractor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.