Michael Gagon, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

292947-2401 Issued in UT

Practice address

590 E 100 N
Suite 1
Price, UT 84501-2640

Phone

(435) 613-1500

Fax

(435) 613-1501

NPI assigned

Jul 21, 2006

Sex

Male

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

Enrolled in UT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prorehab Physical TherapyGroup PAC ID 5193706539, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Prorehab Physical Therapy

  • Physical Therapist
  • Price, UT
  • NPI 1437175403

  UT

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431302400000",
    "number": "1700807484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 933",
            "city": "PRICE",
            "state": "UT",
            "postal_code": "845010933",
            "telephone_number": "435-613-1500",
            "fax_number": "435-613-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 E 100 N",
            "address_2": "SUITE 1",
            "city": "PRICE",
            "state": "UT",
            "postal_code": "845012640",
            "telephone_number": "435-613-1500",
            "fax_number": "435-613-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGON",
        "first_name": "MICHAEL",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2015-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "292947-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Ashley Freeman
• Alaena Fryer
• Deanna Fulcher
• Loahnna Funk
• Kenneth Alan Gagnon, PHARM.D.
• Shane D Gagon, M.D.
• Austyn Gallegos
• Amy Ganser
• Jessica Garner, PMHNP-BC, FNP-BC
• Daniel B. Garvin, M.D.

• All providers in Price, UT
• Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.