Active NPI
Kendellynn Donna Cavanaugh Gagne, MSPT
- Physical Therapist
- Bourne, MA
National Provider Identifier
1366617573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 15268
- Practice address
- 1 Technology Park Dr
Suite a
Bourne, MA 02532-8336 - Phone
- (508) 743-0465
- NPI assigned
- Apr 29, 2008
- Last updated
- Apr 29, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 15268 | MA | Primary |
Addresses
Primary practice location
1 Technology Park Dr
Suite a
Bourne, MA 02532-8336
Mailing address
35 Spinnaker LN
Pocasset, MA 02559-1911
Phone (508) 563-5412
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 |
|---|---|---|---|
| 15268 | MA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehabilitation Hospital of the Cape and Islands, Corporation | Past | Accepting new patients |
Organizations & group practices 1
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 Spaulding Rehabilitation Hospital - Cape Cod
- Rehabilitation Hospital
- E Sandwich, MA
- NPI 1265489736
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209427200000",
"number": "1366617573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 SPINNAKER LN",
"city": "POCASSET",
"state": "MA",
"postal_code": "025591911",
"telephone_number": "508-563-5412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 TECHNOLOGY PARK DR",
"address_2": "SUITE A",
"city": "BOURNE",
"state": "MA",
"postal_code": "025328336",
"telephone_number": "508-743-0465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAVANAUGH GAGNE",
"first_name": "KENDELLYNN",
"middle_name": "DONNA",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-29",
"last_updated": "2008-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "15268",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bourne, MA
- Deborah Breidenbach
- Brookside Radiology Consultants, Inc.
- Heather Lynn Brunelle, COTA
- Cape Cod Nursing and Rehab LLC
- Mark P Caron, LICSW
- Chelsey Helmke Licsw LLC
- Megan Collyer, M.D.
- Community Health Center of Cape Cod, Inc.
- Community Health Center of Cape Cod, Inc.
- Jennifer Robinette Conniff, MSW, LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.