Ashley Gagnon

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

1696 Cactus Wren Dr
Lake Havasu City, AZ 86403-2840

Phone

(928) 208-7551

NPI assigned

Feb 21, 2022

Last updated

Feb 21, 2022By the provider in NPPES

Sex

Female

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 MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Star Family Medicine PLLCGroup PAC ID 1759796949, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cuyuna Regional Medical Center Hospital, Crosby, MN, CCN 241353

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ashley.gagnon.1@23245.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/23245/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• North Star Family Medicine PLLC

  • Clinic/Center
  • Brainerd, MN
  • NPI 1265022370
  Medicare reassignment Care Compare group
• KM Nutrition, LLC

  • Registered Dietitian
  • Brainerd, MN
  • NPI 1548955313
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cuyuna Regional Medical Center

  • Critical Access Hospital
  • Crosby, MN
  • NPI 1538143896
  Care Compare affiliation

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

{
    "created_epoch": "1645401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1750036430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1696 CACTUS WREN DR",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864032840",
            "telephone_number": "928-208-7551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1696 CACTUS WREN DR",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864032840",
            "telephone_number": "928-208-7551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "ASHLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-21",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward P Fuller, MD
• Maria Fuller, CRNA
• David Funk, PT, DPT
• Melissa Christine Funk, HIS
• Allison Joy Fuoco
• Gabriel Gregory Galante, DDS
• Claudine Gallegos, CMT
• Linda Galloway
• Christopher Lee Gamble
• Jennifer Nicole Rusch Garcia, D.C.

• Medical Physician Assistant in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; 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.
• 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.