Lisa Marie Gagnon, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

002510 Issued in CT

Practice address

230 Boston Post Rd
Madison, CT 06443-2225

Phone

(203) 245-0496

Fax

(203) 245-8697

NPI assigned

Mar 16, 2006

Last updated

Aug 9, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lgagnon3159@direct.ynhh.org
• Direct secure messaging: lisa.gagnon.1@27673.direct.athenahealth.com

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.

• Connecticut Pediatric Otolaryngology

  • Specialist
  • Madison, CT
  • NPI 1750402038
  NPD (past)
• Prohealth Physicians PC

  • Family Medicine Physician
  • Farmington, CT
  • NPI 1720194053

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376006400000",
    "number": "1417926957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 BOSTON POST RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064432225",
            "telephone_number": "203-245-0496",
            "fax_number": "203-245-8697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 BOSTON POST RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064432225",
            "telephone_number": "203-245-0496",
            "fax_number": "203-245-8697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2013-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CT",
            "license": "002510",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "002510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Frick, PSY.D.
• Madison Alaia Fucci
• Bryn Funk, PT
• Katrina Louise Furey, M.D.
• Robert Fusco Sr.
• Denise Gallo, APRN
• Lisbeth Gannon, LPC
• Sarah Garcia, LMFT
• Joyce Gendler, LPC, REAT, NCC
• Nicole Marie Gentili, M.S.W.

• Nurse Practitioner in Madison, CT
• Providers in Madison, CT by specialty
• Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2013; 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.