Jennifer Linn Gagne', PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

4515 Premier Dr Ste 402a
High Point, NC 27265-8356

Phone

(336) 702-1255

Fax

(336) 802-2201

NPI assigned

Jun 23, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Wake Forest Health Network LLC

  • Pediatrics Physician
  • Greensboro, NC
  • NPI 1477785756
  Medicare reassignment NPD
• Wake Forest Health Network LLC

  • Family Medicine Physician
  • Jefferson, NC
  • NPI 1518393560
  NPD
• Cornerstone Health Care LLC

  • Clinical Medical Laboratory
  • Conover, NC
  • NPI 1871159145
  NPD (past)
• Cornerstone Health Care PA

  • Cardiovascular Disease Physician
  • Statesville, NC
  • NPI 1275914046
  NPD (past)

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

{
    "created_epoch": "1277251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1033420229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 WESTCHESTER DR",
            "address_2": "STE 850",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627254",
            "telephone_number": "336-802-2536",
            "fax_number": "336-802-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 PREMIER DR STE 402A",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272658356",
            "telephone_number": "336-702-1255",
            "fax_number": "336-802-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNE'",
        "first_name": "JENNIFER",
        "middle_name": "LINN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-23",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6001225",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Elisabeth Fuller, NP
• Ellen Heath Fulp, PHARM.D.
• Kimberly Fulp, M.A., CCC-SLP
• G. Chris Holdaway, DDS, PA
• Tony Anthony Gaddy
• Leigh Maria Gagnon, LCSWA
• Michael Deleon Gaither, D.O.
• Jamie Galasso, MSW, LCASA
• Anne Gallagher
• Warren G. Gallemore, MD

• Psychologist in High Point, NC
• Providers in High Point, NC by specialty
• Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.