Matthew Philip Gagnon, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

27554 Issued in NE

Practice address

655 7TH St BLDG 700
Robins Afb, GA 31098-2227

Phone

(478) 327-7758

Fax

(478) 327-7585

NPI assigned

Jul 19, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1477808012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 7TH ST BLDG 700",
            "city": "ROBINS AFB",
            "state": "GA",
            "postal_code": "310982227",
            "telephone_number": "478-327-7758",
            "fax_number": "478-327-7585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 7TH ST BLDG 700",
            "city": "ROBINS AFB",
            "state": "GA",
            "postal_code": "310982227",
            "telephone_number": "478-327-7758",
            "fax_number": "478-327-7585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "MATTHEW",
        "middle_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-19",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "27554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Ferguson
• Amanda Marie Fletcher, FNP-C
• Michael Rutledge Frayser, D.O.
• Jeffrey Freeland
• Victoria Freeney, LCSW
• Seritha Carol Gilbert, RPH
• Tommi Lynn Gill, NP
• Kimberly Grady, DDS
• John Gravgaard, MPAS, PA-C
• Emily Graze, LCPC, PSY.D., ABPP

• Family Medicine Physician in Robins Afb, GA
• Providers in Robins Afb, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.