Individual provider Active NPI

Mariah Arno Gagne

  • Gerontology Occupational Therapist
  • Cape Elizabeth, ME
National Provider Identifier
1083111488
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Occupational TherapistTaxonomy code 225XG0600X
License
OT3081 Issued in ME
Practice address
2 Davis Point LN Unit 1a
Cape Elizabeth, ME 04107-2628
Phone
(207) 767-9773
NPI assigned
Apr 11, 2018
Last updated
Jul 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Occupational Therapist 225XG0600X OT3081 ME Primary

Addresses

Primary practice location

2 Davis Point LN Unit 1a
Cape Elizabeth, ME 04107-2628

Mailing address

2 Davis Point LN Unit 1a
Cape Elizabeth, ME 04107-2628
Phone (207) 767-9773

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210922003023 NV Practitioner - Occupational Therapist in Private Practice 0345503678 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT3081MEMDGerontology Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic and Neurological Rehab Inc CurrentSince Jun 15, 2021 Accepting new patients
Outbound Therapy Services LLC CurrentSince Mar 1, 2025 Accepting new patients
Orthopaedic and Neurological Rehabilitation, Speech Pathology, Inc CurrentSince Jun 15, 2021 Accepting new patients

Locations

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

5255 Kietzke Ln
Reno, NV 89511

8500 Bluffstone Cv
Ste A201
Austin, TX 78759
Phone (512) 220-5252

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1083111488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 DAVIS POINT LN UNIT 1A",
            "city": "CAPE ELIZABETH",
            "state": "ME",
            "postal_code": "041072628",
            "telephone_number": "207-767-9773",
            "fax_number": "207-541-9212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 DAVIS POINT LN UNIT 1A",
            "city": "CAPE ELIZABETH",
            "state": "ME",
            "postal_code": "041072628",
            "telephone_number": "207-767-9773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNE",
        "first_name": "MARIAH",
        "middle_name": "ARNO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-11",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "ME",
            "license": "OT3081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Elizabeth, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.