Active NPI
Alexander Scott Gagnon, PT, AT
- Physical Therapist
- Marquette, MI
National Provider Identifier
1740715747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 100 Edgewood Dr
Marquette, MI 49855-9229 - Phone
- (906) 360-9869
- NPI assigned
- Apr 27, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
100 Edgewood Dr
Marquette, MI 49855-9229
Mailing address
100 Edgewood Dr
Marquette, MI 49855-9229
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": "1493251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624233600000",
"number": "1740715747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 EDGEWOOD DR",
"city": "MARQUETTE",
"state": "MI",
"postal_code": "498559229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 EDGEWOOD DR",
"city": "MARQUETTE",
"state": "MI",
"postal_code": "498559229",
"telephone_number": "906-360-9869"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAGNON",
"first_name": "ALEXANDER",
"middle_name": "SCOTT",
"credential": "PT, AT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-04-27",
"last_updated": "2021-06-21",
"certification_date": "2021-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marquette, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.