Susan Gagner, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PA2171 Issued in ME

Practice address

C/O New Beginnings PT
1068 Main Street - Box 11
Sanford, ME 04073

Phone

(207) 324-1611

Fax

(207) 324-1611

NPI assigned

Jun 27, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• PLW Inc

  dba New Beginnings

  • Pediatric Physical Therapist
  • Sanford, ME
  • NPI 1457495442
  NPD (past)

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649207192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "C/O NEW BEGINNINGS PT",
            "address_2": "1068 MAIN STREET - BOX 11",
            "city": "SANFORD",
            "state": "ME",
            "postal_code": "04073",
            "telephone_number": "207-324-1611",
            "fax_number": "207-324-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "C/O NEW BEGINNINGS PT",
            "address_2": "1068 MAIN STREET - BOX 11",
            "city": "SANFORD",
            "state": "ME",
            "postal_code": "04073",
            "telephone_number": "207-324-1611",
            "fax_number": "207-324-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNER",
        "first_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "ME",
            "license": "PA2171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Fish, LMT
• Drew Fitzgibbon, DMD
• Mia Lynn Foley, LCSW
• William F Frank, MD
• Michelle Frasier
• Amanda Reavis Gibson, M.D.
• Jenner Gibson, M.D.
• Girijavar LLC
• Katharine Anne Gladstone
• Goodall Health Partners

• Physical Therapy Assistant in Sanford, ME
• Providers in Sanford, ME by specialty
• Physical Therapy Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.