Kelli P Gagne, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

20033 Issued in SC

Practice address

331 E Main St Ste 200
Rock Hill, SC 29730-5384

Phone

(704) 438-0687

Fax

(844) 308-7996

NPI assigned

Sep 21, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in SC, NC2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• Gagne Behavioral Health Care PA

  • Psychiatric/Mental Health Nurse Practitioner
  • Rock Hill, SC
  • NPI 1720447659

  NC

  Medicare reassignment Authorized official
• Fort Mill Senior Wellness LLC

  • Nurse Practitioner
  • Rock Hill, SC
  • NPI 1336992601

  Psychiatric/Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1861775264",
    "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": "297305384",
            "telephone_number": "704-438-0687",
            "fax_number": "844-308-7996"
        },
        {
            "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": "297305384",
            "telephone_number": "704-438-0687",
            "fax_number": "844-308-7996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNE",
        "first_name": "KELLI",
        "middle_name": "P",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-21",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "4815",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5008661",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "20033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joy Doner Furchner, MSPT
• Ebony Futrell
• Diane Louise Gabanyic, MS OTR L
• Gagne Behavioral Health Care PA
• Gagne Medical Health Care P.a.
• Jennifer Gainer, PA-C
• Nichole Shiontaine Gaines, FNP
• Tonya Gaines, OTR/L
• Walter Calvin Gainey, A.T.,C., S.C.A.T.
• Barvette Gaither, LMSW

• 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 Sep 20, 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.