Gagne Behavioral Health Care PA

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

20033 Issued in SC

Legal business name

GAGNE BEHAVIORAL HEALTH CARE PA

Practice address

331 E Main St Ste 200
Rock Hill, SC 29730-5371

Phone

(704) 438-0687

NPI assigned

Feb 20, 2016

Organization subpart

No

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

Authorized official

Name

Kelli P GagneNPI 1861775264

Title

Aprn

Phone

(704) 438-0687

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC, NC2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelli P Gagne, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Rock Hill, SC
  • NPI 1861775264

  NC

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1455926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637539200000",
    "number": "1720447659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 E MAIN ST STE 200",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297305371",
            "telephone_number": "704-438-0687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 E MAIN ST STE 200",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297305371",
            "telephone_number": "704-438-0687"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6000 Fairview Rd Ste 1200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282102252",
            "country_code": "US",
            "telephone_number": "704-438-0687",
            "fax_number": "844-591-0104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GAGNE BEHAVIORAL HEALTH CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-20",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A",
        "authorized_official_last_name": "GAGNE",
        "authorized_official_first_name": "KELLI",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "APRN",
        "authorized_official_telephone_number": "704-438-0687"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "20033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert V. Fulmer, MD
• Vonda Fulton, RBT
• Joy Doner Furchner, MSPT
• Ebony Futrell
• Diane Louise Gabanyic, MS OTR L
• Gagne Medical Health Care P.a.
• Kelli P Gagne, APRN
• Jennifer Gainer, PA-C
• Nichole Shiontaine Gaines, FNP
• Tonya Gaines, OTR/L

• Psychiatric/Mental Health Nurse Practitioner in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Psychiatric/Mental Health Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.