Active NPI
Erin Gagne, FNP-C
- Nurse Practitioner
- Winston Salem, NC
National Provider Identifier
1710420062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 5009118
- Practice address
- 4692 Brownsboro Rd
Winston Salem, NC 27106-3410 - Phone
- (336) 251-1114
- Fax
- (336) 251-1117
- NPI assigned
- Nov 18, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 5009118 | NC | Primary |
Addresses
Primary practice location
4692 Brownsboro Rd
Winston Salem, NC 27106-3410
Mailing address
1100 South Blvd Apt 573
Charlotte, NC 28203-6534
Phone (401) 359-1561
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2021 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479427200000",
"number": "1710420062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 SOUTH BLVD APT 573",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282036534",
"telephone_number": "401-359-1561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4692 BROWNSBORO RD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271063410",
"telephone_number": "336-251-1114",
"fax_number": "336-251-1117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAGNE",
"first_name": "ERIN",
"name_prefix": "Miss",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-18",
"last_updated": "2016-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NC",
"license": "5009118",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.