Active NPI
Adam Paul Gagne
- Pharmacist
- Unicoi, TN
National Provider Identifier
1346740479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 35964
- Practice address
- 110 Rocky Bottom Dr
Unicoi, TN 37692-4030 - Phone
- (423) 743-9998
- NPI assigned
- Feb 15, 2018
- Last updated
- Feb 15, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 35964 | TN | Primary |
Addresses
Primary practice location
110 Rocky Bottom Dr
Unicoi, TN 37692-4030
Mailing address
110 Rocky Bottom Dr
Unicoi, TN 37692-4030
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 |
|---|---|---|---|
| 35964 | TN | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East, LP | Past | Accepting new patients | |
| Wal-Mart Stores East LP | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Wal-Mart Pharmacy 10-3852
- Community/Retail Pharmacy
- Unicoi, TN
- NPI 1851333090
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518652800000",
"number": "1346740479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 ROCKY BOTTOM DR",
"city": "UNICOI",
"state": "TN",
"postal_code": "376924030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 ROCKY BOTTOM DR",
"city": "UNICOI",
"state": "TN",
"postal_code": "376924030",
"telephone_number": "423-743-9998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAGNE",
"first_name": "ADAM",
"middle_name": "PAUL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-02-15",
"last_updated": "2018-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "35964",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Unicoi, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.