Individual provider Active NPI

Paula Gagnon, NP-C

  • Family Nurse Practitioner
  • Rutland, VT
National Provider Identifier
1558773705
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN269635 Issued in MA
Practice address
215 Stratton Rd
Rutland, VT 05701-4621
Phone
(802) 773-3386
NPI assigned
May 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN269635 MA Primary

Addresses

Primary practice location

215 Stratton Rd
Rutland, VT 05701-4621

Mailing address

302 Howe St
Methuen, MA 01844-2610

Other practice location 1

60 Kendrick St
Needham, MA 02494-2726
Phone (800) 370-3561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211119000396 VT Practitioner - Nurse Practitioner 4385860519 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of the Rutland Region, Inc. CurrentSince Dec 1, 2021 Accepting new patients
Community Health Centers of the Rutland Region, Inc CurrentSince Dec 1, 2021 Accepting new patients
Community Health Centers of the Rutland Region Inc Current Accepting new patients
Community Health Centers of the Rutland Region Inc CurrentSince Dec 1, 2021 Accepting new patients
Community Health Centers of the Rutland Region, Inc. CurrentSince Dec 1, 2021 Accepting new patients
Community Health Centers of the Rutland Region, Inc. CurrentSince Dec 1, 2021 Accepting new patients
Community Health Centers of the Rutland Region, Inc. CurrentSince Dec 1, 2021 Accepting new patients

Locations

275 VT 30 N
Bomoseen, VT 05732
Phone (802) 468-5641

420 Grove St
Brandon, VT 05733
Phone (802) 247-6305

215 Stratton Rd
Rutland, VT 05701
Phone (802) 773-3386

1 General Wing Rd
Rutland, VT 05701
Phone (802) 773-9131

71 Allen St
Ste 402
Rutland, VT 05701
Phone (800) 468-9118

2987 Vt Route 22A
Shoreham, VT 05770
Phone (802) 897-7000

278 Vt Route 149
West Pawlet, VT 05775
Phone (800) 468-9118

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1400716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1558773705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 HOWE ST",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018442610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 STRATTON RD",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014621",
            "telephone_number": "802-773-3386"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60 Kendrick St",
            "address_purpose": "LOCATION",
            "city": "Needham",
            "state": "MA",
            "postal_code": "024942726",
            "country_code": "US",
            "telephone_number": "800-370-3561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "PAULA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-22",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN269635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rutland, VT

Sources for this page

Verify at the official NPI Registry.