Melissa Gagnon, OTD, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

2854 Issued in AK

Practice address

653 W Fairview Ave
Apt I
Homer, AK 99603-7444

Phone

(907) 756-1101

NPI assigned

Oct 14, 2014

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)

Enrolled

Practice roles

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.

• Cirque Therapy, LLC

  • Pediatric Occupational Therapist
  • Homer, AK
  • NPI 1275937013
  NPD (past) Authorized official

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

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413244800000",
    "number": "1679977029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2157",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996032157",
            "telephone_number": "907-756-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 W FAIRVIEW AVE",
            "address_2": "APT I",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037444",
            "telephone_number": "907-756-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "MELISSA",
        "name_prefix": "Dr.",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-14",
        "last_updated": "2014-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AK",
            "license": "2854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Forquer
• Raymond D. Fowler, M.D.
• Peggy Jean Frazier, FNP-C
• Gregory Fries, LMFT
• Frontier Natural Health
• Annie Marie Garay
• Devry Garity, CPNP
• Garret Lamendola Sitenga
• Angela Threeton Gasper, M.S. CCC-SLP
• Carey Brent Gear, MD

• All providers in Homer, AK
• Occupational Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2014; 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.