Alan Gagnon, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

0110003260 Issued in VA

Practice address

5875 Bremo Rd
Suite G-5
Richmond, VA 23226-1934

Phone

(804) 287-7840

Fax

(804) 287-7845

NPI assigned

Jun 27, 2008

Sex

Male

Sole proprietor

No

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.

• Bon Secours Medical Group Richmond Specialty Care LLC

  • Cardiovascular Disease Physician
  • Richmond, VA
  • NPI 1477112225
  NPD (past)
• Bon Secours-St. Mary'S Hospital of Richmond, Inc.

  • Infectious Disease Physician
  • Richmond, VA
  • NPI 1063772143
  NPD (past)
• Bon Secours-St. Mary'S Hospital of Richmond, Inc.

  • Pediatric Neurodevelopmental Disabilities Physician
  • Richmond, VA
  • NPI 1427361922
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 19, 2010.

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279497600000",
    "number": "1063674380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5875 BREMO RD",
            "address_2": "SUITE G-5",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261934",
            "telephone_number": "804-287-7840",
            "fax_number": "804-287-7845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5875 BREMO RD",
            "address_2": "SUITE G-5",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261934",
            "telephone_number": "804-287-7840",
            "fax_number": "804-287-7845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "ALAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-27",
        "last_updated": "2010-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NH",
            "license": "0284P",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110003260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C06778",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabrielle'S House
• Suneeta Gadde, M.D
• Courtney Gaeta
• Dilafruz Gafur
• Ekaterina Peredo Gagarin, BCBA, LBA
• Katiemarie C Gagnon, PNP
• Sierra Gaines, RN
• Julius Gaiters
• Pooja Patel Gajulapalli, MD
• Robert Galban Jr., O.D.

• All providers in Richmond, VA
• Surgical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2010; 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.