Active NPI
Erica Gagnon, OD
- Optometrist
- Marysville, MI
National Provider Identifier
1710430053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901005009
- Practice address
- 3184 Gratiot Blvd
Marysville, MI 48040-1488 - Phone
- (810) 364-5520
- NPI assigned
- Aug 3, 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901005009 | MI | Primary |
Addresses
Primary practice location
3184 Gratiot Blvd
Marysville, MI 48040-1488
Mailing address
118 Cass Ave
Mount Clemens, MI 48043-2204
Phone (586) 468-7370
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470182400000",
"number": "1710430053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "118 CASS AVE",
"city": "MOUNT CLEMENS",
"state": "MI",
"postal_code": "480432204",
"telephone_number": "586-468-7370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3184 GRATIOT BLVD",
"city": "MARYSVILLE",
"state": "MI",
"postal_code": "480401488",
"telephone_number": "810-364-5520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAGNON",
"first_name": "ERICA",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-03",
"last_updated": "2016-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901005009",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marysville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.