Jean-Phillippe Gagnon, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1908R76444 Issued in AZ

Practice address

2451 S Avenue a Ste C101
Yuma, AZ 85364-7360

Phone

(928) 336-1290

NPI assigned

Jun 23, 2017

Sex

Male

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1498176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498176000000",
    "number": "1548780273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2575 W 24TH ST APT 128",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853646065",
            "telephone_number": "506-962-2176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 S AVENUE A STE C101",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647360",
            "telephone_number": "928-336-1290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "JEAN-PHILLIPPE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-23",
        "last_updated": "2017-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "1908R76444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Frye, PA-C
• Tomasz Sebastian Gregory Fudalewski, MD
• Jacqueline Fuentes Camacho, NP
• Steven Charles Funk, M.D.
• Akhil Reddy Gade, MD
• Natalia Varenka Galarza Carrazco, M.D.
• Gail Galate, AGACNP-BC
• Carlos Ignacio Galindo
• Vanessa Galindo
• Joseph D Gallemore, D.D.S.

• Family Medicine Physician in Yuma, AZ
• Providers in Yuma, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2017; 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.