Suzanne Gagnon, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD052796L Issued in PA

Practice address

212 Church Rd
North Wales, PA 19454-4140

Phone

(215) 616-3688

Fax

(215) 616-3009

NPI assigned

May 19, 2008

Sex

Female

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211155200000",
    "number": "1497912406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 CHURCH RD",
            "city": "NORTH WALES",
            "state": "PA",
            "postal_code": "194544140",
            "telephone_number": "215-616-3688",
            "fax_number": "215-616-3009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 CHURCH RD",
            "city": "NORTH WALES",
            "state": "PA",
            "postal_code": "194544140",
            "telephone_number": "215-616-3688",
            "fax_number": "215-616-3009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "SUZANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-19",
        "last_updated": "2008-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD052796L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carole D Frankenfield, OT
• Stephanie Fratantaro, LPC
• Stephanie Fudge, MA, LPC, NCC
• Fuller Family Chiropractic
• David Scott Fuller, DC
• Pearl Valentine Guinto Galido, DO
• John M Gatto, RPH
• Erin Gaul, MS, CCC-SLP
• Gaurdian Health Services
• Caroline Elizabeth Gavin, MA, CF-SLP

• Internal Medicine Physician in North Wales, PA
• Providers in North Wales, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; 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.