Melanie Anne Gagnon, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT008447L Issued in PA

Practice address

436 East St
Bloomsburg, PA 17815-1849

Phone

(717) 514-1057

NPI assigned

Jul 18, 2005

Last updated

Oct 22, 2019By 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

Other identifiers 9

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Capital Area Physical Therapy, Inc

  dba Capital Area PT

  • Physical Therapy Clinic/Center
  • Harrisburg, PA
  • NPI 1528226123
  NPD (past) Authorized official
• Vibrantcare Outpatient Rehabilitation West Inc

  dba VibrantCare Rehabilitation

  • Physical Therapy Clinic/Center
  • Phoenix, AZ
  • NPI 1114921871
  NPD (past)
• Vibrantcare Outpatient Rehabilitation West Inc

  dba VibrantCare Outpatient Rehabilitation - Tucson East

  • Physical Therapy Clinic/Center
  • Tucson, AZ
  • NPI 1699779223
  NPD (past)

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1770582249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 EAST ST",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178151849",
            "telephone_number": "717-514-1057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 EAST ST",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178151849",
            "telephone_number": "717-514-1057"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4386 Sturbridge Dr",
            "address_2": "Suite 102",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "PA",
            "postal_code": "171103668",
            "country_code": "US",
            "telephone_number": "717-540-3446",
            "fax_number": "717-540-3447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "MELANIE",
        "middle_name": "ANNE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-18",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT008447L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE PPO",
            "identifier": "7911276",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "1537903",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEVON HEALTH SERVICES",
            "identifier": "251844378",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "650021545",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01840210",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY",
            "identifier": "20036904",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "02202001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE HMO",
            "identifier": "2584842",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "GA920917",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Molly Cezanne Fragale, CNM
• Elizabeth Ann Fritz, CRNP
• Penny Fritz
• Amanda Fulmer
• Camry Gabel
• Melissa Ann Garcia Araniva
• Gavin Garlinger
• Anna Garrison
• Stacy Marie Gaugler
• Geisinger Bloomsburg Health Care Center

• Physical Therapist in Bloomsburg, PA
• Providers in Bloomsburg, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.