Individual provider Active NPI

Verna Gaddy, RN

  • Registered Nurse
  • Gallup, NM
National Provider Identifier
1801080718
Registry record updated Nov 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R18329 Issued in NM
Practice address
516 East Nizhoni Blvd
Gallup, NM 87301-1337
Phone
(505) 722-1440
Fax
(505) 722-1487
NPI assigned
Sep 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R18329 NM Primary

Addresses

Primary practice location

516 East Nizhoni Blvd
Gallup, NM 87301-1337

Mailing address

913 E Logan Ave
Gallup, NM 87301-5565
Phone (505) 722-8974

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R18329NMMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194220800000",
    "number": "1801080718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 E LOGAN AVE",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015565",
            "telephone_number": "505-722-8974",
            "fax_number": "505-722-1487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 EAST NIZHONI BLVD",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873011337",
            "telephone_number": "505-722-1440",
            "fax_number": "505-722-1487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADDY",
        "first_name": "VERNA",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-04",
        "last_updated": "2007-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "R18329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallup, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.