Roger R Gagnon

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

ROGER R GAGNON

Doing business as

Maine Mall Eye Care

Practice address

510 Maine Mall
South Portland, ME 04106-3238

Phone

(207) 775-2030

NPI assigned

Aug 29, 2007

Organization subpart

No

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

Authorized official

Name

Roger R Gagnon, O.D.

Title

Ceo

Phone

(207) 775-2030

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Maine Mall Eye Care Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kirsten Weitzel Turrisi, OD

  • Optometrist
  • South Portland, ME
  • NPI 1770135618
  NPD (past)

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196812800000",
    "number": "1649464983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 MAINE MALL",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063238",
            "telephone_number": "207-775-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 MAINE MALL",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063238",
            "telephone_number": "207-775-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGER R GAGNON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-29",
        "last_updated": "2007-12-05",
        "status": "A",
        "authorized_official_last_name": "GAGNON",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-775-2030",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1124128913",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "014336",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maine Mall Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dana Robison, FNP
• Heidi A Roche, MD
• Margarethe L. Roderick, LCSW
• Rodney J. Voisine, MD, PA
• Theresa Roelke, NP
• Andrew Mark Rogers, M.D.
• Jillian Rolfe, LMSW-CC
• Gregory C. Romanoff, M.S.ED. LADC CCS
• Rachel Romanski, LCPC-C
• Ronald M. Cedrone OD, LLC

• Optometrist in South Portland, ME
• Providers in South Portland, ME by specialty
• Optometrist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.