Individual provider Active NPI

Gisela Woggon, M.A., LMFT

  • Marriage & Family Therapist
  • Nampa, ID
National Provider Identifier
1790964724
Registry record updated Oct 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT 3527 Issued in ID
Practice address
1009 W Hemingway Blvd
Nampa, ID 83651-1763
Phone
(208) 453-8915
Fax
(208) 453-8937
NPI assigned
Oct 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT 3527 ID Primary

Addresses

Primary practice location

1009 W Hemingway Blvd
Nampa, ID 83651-1763

Mailing address

1009 W. Hemingway Boulevard
Nampa, ID 83651
Phone (208) 453-8915

Other identifiers 1

IdentifierTypeStateIssuer
LMFT 3527OtherIDIBOL

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

LicenseStateTypeSpecialty
LMFT 3527IDMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Inc, Past Accepting new patients
Affinity Inc. Past Accepting new patients

Organizations & group practices 2

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": "1193356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193356800000",
    "number": "1790964724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 W. HEMINGWAY BOULEVARD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "83651",
            "telephone_number": "208-453-8915",
            "fax_number": "208-453-8937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 W HEMINGWAY BLVD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836511763",
            "telephone_number": "208-453-8915",
            "fax_number": "208-453-8937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOGGON",
        "first_name": "GISELA",
        "name_prefix": "Ms.",
        "credential": "M.A., LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-26",
        "last_updated": "2007-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "ID",
            "license": "LMFT 3527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBOL",
            "identifier": "LMFT 3527",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; 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.