NPIMap

Individual provider Active NPI

Shane D Gagon, M.D.

  • Family Medicine Physician
  • Price, UT
National Provider Identifier
1508951328
Registry record updated Dec 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
361555-1205 Issued in UT
Practice address
377 N Fairgrounds Rd
Price, UT 84501-4208
Phone
(435) 613-2200
Fax
(435) 613-2201
NPI assigned
Oct 4, 2006
Last updated
Dec 31, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 361555-1205 UT Primary

Addresses

Primary practice location

377 N Fairgrounds Rd
Price, UT 84501-4208

Mailing address

PO Box 1437
Price, UT 84501-1437
Phone (435) 613-2200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address shane.gagon@gfp.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031114000299 UT Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 6204740251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
University of Utah School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shane D Gagon MD, PCGroup PAC ID 9335236868, 9 clinicians

Practice addresses (Care Compare)

377 No Fairgrounds Rd
Gagon Family Practice
Price, UT 84501-4211
Phone (435) 613-2200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions13
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Shane D Gagon MD, PC Family Medicine CurrentSince Jun 1, 2000 Accepting new patients

Locations

377 N Fairgrounds Rd
Price, UT 84501
Phone (435) 613-2200

Interoperability endpoints

  • Direct secure messaging: ddi9738@yourcarecommunity.org

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640908800000",
    "number": "1508951328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1437",
            "city": "PRICE",
            "state": "UT",
            "postal_code": "845011437",
            "telephone_number": "435-613-2200",
            "fax_number": "435-613-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 N FAIRGROUNDS RD",
            "city": "PRICE",
            "state": "UT",
            "postal_code": "845014208",
            "telephone_number": "435-613-2200",
            "fax_number": "435-613-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGON",
        "first_name": "SHANE",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2021-12-31",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "361555-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shane.gagon@gfp.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "eclinical direct plus",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "377 N Fairgrounds Rd",
            "city": "Price",
            "state": "UT",
            "country_code": "US",
            "postal_code": "845014208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Price, UT

Sources for this page

Verify at the official NPI Registry.