Individual provider Active NPI

Jennifer Lynn Ligon-Gaston, FNP-C

  • Family Nurse Practitioner
  • Montgomery, TX
National Provider Identifier
1780037861
Registry record updated Jul 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP131237 Issued in TX
Practice address
19782 Highway 105 W
Suite 111
Montgomery, TX 77356-3103
Phone
(936) 582-0220
Fax
(936) 582-0222
NPI assigned
Jul 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP131237 TX Primary

Addresses

Primary practice location

19782 Highway 105 W
Suite 111
Montgomery, TX 77356-3103

Mailing address

19782 Highway 105 W
Suite 111
Montgomery, TX 77356-3103
Phone (936) 582-0220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171027002498 TX Practitioner - Nurse Practitioner 1052687548

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP131237TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular Care Providers, Inc. Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468368000000",
    "number": "1780037861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19782 HIGHWAY 105 W",
            "address_2": "SUITE 111",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773563103",
            "telephone_number": "936-582-0220",
            "fax_number": "936-582-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19782 HIGHWAY 105 W",
            "address_2": "SUITE 111",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773563103",
            "telephone_number": "936-582-0220",
            "fax_number": "936-582-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGON-GASTON",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-13",
        "last_updated": "2016-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP131237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, TX

Sources for this page

Verify at the official NPI Registry.