Active NPI
Marie Gagne, PT
- Physical Therapist
- Manchester, NH
National Provider Identifier
1124544879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 8737
- Practice address
- 3000 Goffs Falls Rd Ste 101
Manchester, NH 03103-6109 - Phone
- (800) 995-2673
- Fax
- (888) 979-6551
- NPI assigned
- Aug 15, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT30170 | FL | |
| Physical Therapist | 225100000X | 3860 | ID | |
| Physical Therapist | 225100000X | 5007 | NM | |
| Physical Therapist | 225100000X | 8737 | SC | Primary |
Addresses
Primary practice location
3000 Goffs Falls Rd Ste 101
Manchester, NH 03103-6109
Mailing address
3000 Goffs Falls Rd Ste 101
Manchester, NH 03103-6109
Phone (800) 995-2673
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT30170 | FL | MD | Physical Therapist |
| 5007 | NM | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502755200000",
"number": "1124544879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 GOFFS FALLS RD STE 101",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031036109",
"telephone_number": "800-995-2673",
"fax_number": "888-979-6551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 GOFFS FALLS RD STE 101",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031036109",
"telephone_number": "800-995-2673",
"fax_number": "888-979-6551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAGNE",
"first_name": "MARIE",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-15",
"last_updated": "2017-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT30170",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "3860",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NM",
"license": "5007",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "8737",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Manchester, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.