Keith Andrew Gagnon, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

57.258240 Issued in OH

Practice address

395 W 12TH Ave Ste 662
Columbus, OH 43210-1267

Phone

(614) 293-8704

NPI assigned

Mar 25, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kgagnon1557749@direct.osumc.edu

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.

• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1742860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1669274106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 W 12TH AVE STE 662",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101267",
            "telephone_number": "614-293-8704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 W 12TH AVE STE 662",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101267",
            "telephone_number": "614-293-8704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "KEITH",
        "middle_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-25",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "57.258240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gianni Claudio Gagliardi, PHARMD
• Leslie E Gagne, LISW, LICDC
• Paul Joseph Gagne, DPT
• Cristina Frances Gagnon, PA-C
• Jennifer Gagnon, CDCA, APS
• Gahanna Counseling, LLC
• Gahanna Group Health, LLC
• Gahanna Physical Therapy Limited Partnership
• Gahanna Urgent Care
• Reinhard A Gahbauer, MD

• Surgery Physician in Columbus, OH
• Providers in Columbus, OH by specialty
• Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; 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.