Ashley Gagnon, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT3949 Issued in ME

Practice address

11 Main Rd North
Hampden, ME 04444

Phone

(207) 862-3906

Fax

(207) 862-2892

NPI assigned

Jul 10, 2018

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Ube Physical Therapy and Performance LLC

  • Physical Therapy Clinic/Center
  • Bangor, ME
  • NPI 1508226119

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1154817419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 MAINE RD NORTH",
            "address_2": "PO BOX 227",
            "city": "HAMPDEN",
            "state": "ME",
            "postal_code": "04444",
            "telephone_number": "207-862-3906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 MAIN RD NORTH",
            "city": "HAMPDEN",
            "state": "ME",
            "postal_code": "04444",
            "telephone_number": "207-862-3906",
            "fax_number": "207-862-2892"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 Broadway Ste 1",
            "address_purpose": "LOCATION",
            "city": "Bangor",
            "state": "ME",
            "postal_code": "044015205",
            "country_code": "US",
            "telephone_number": "207-990-0188",
            "fax_number": "207-990-6604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "ASHLEY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-10",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT3949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "6651881",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leigh J Forbush, DO
• Charity-Leigh Fournier
• Fraser Clinical Consultation Services
• Wallace J Fraser Jr., LCPC
• Fundamental Foot Care, PLLC
• Emily Grace Gazitua, D.M.D.
• Gentiva Health Services
• Heather Gilbert
• Daniel Cole Gott, DO
• Alicia Laurell Grant-Singh, FNP

• All providers in Hampden, ME
• Physical Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; 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.