DR. ELLIOTT B GAGNON (NPI# 1417070905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417070905 |
| Entity Type | Individual |
| Full Name | DR. ELLIOTT B GAGNON |
| Credential | M.D. |
| Practice Address |
950 E Bogard Rd Suite 209 Wasilla AK 99654-7184 |
| Practice Telephone | 9073574550 |
| Practice Fax Number | 9073574552 |
| Mailing Telephone | 9073574550 |
| Mailing Fax Number | 9073574552 |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2016-02-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208200000X | Plastic Surgery | A108504 | CA | Allopathic & Osteopathic Physicians |
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
104918 | AK | Allopathic & Osteopathic Physicians |
| Street Address |
950 E BOGARD RD SUITE 209 |
| City | WASILLA |
| State | AK |
| Zip Code | 99654-7184 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831188473 | Laura Jean Peterson | Pediatrics | 950 E Bogard Rd, Ste 233, Wasilla, AK 99654-7184 | 2005-10-17 |
| 1801314927 | Tracie East | Physical Therapist | 950 E Bogard Rd, Wasilla, AK 99654-7184 | 2017-09-08 |
| 1346776150 | Patricia B Payne | Nurse Practitioner | 950 E Bogard Rd, Suite #228, Wasilla, AK 99654-7184 | 2017-05-11 |
| 1578928628 | Gagnon Plastic and Reconstructive Surgery | Plastic Surgery | 950 E Bogard Rd, Suite 209, Wasilla, AK 99654-7184 | 2015-12-16 |
| 1659700292 | Hillary Ryan Linden | Physician Assistant | 950 E Bogard Rd, Suite 103, Wasilla, AK 99654-7184 | 2013-11-04 |
| 1578995304 | Mat-su Neurology, LLC | Clinic/Center | 950 E Bogard Rd, Suite 213, Wasilla, AK 99654-7184 | 2013-08-03 |
| 1114269313 | Odland Family Practice Clinic, LLC | Family Medicine | 950 E Bogard Rd, Suite 234, Wasilla, AK 99654-7184 | 2013-03-26 |
| 1619212479 | Janet L Shelley | Nurse Practitioner | 950 E Bogard Rd, Suite 233, Wasilla, AK 99654-7184 | 2012-12-05 |
| 1366752560 | Mat-su Valley IIi LLC | Internal Medicine | 950 E Bogard Rd, Suite 207, Wasilla, AK 99654-7184 | 2010-10-21 |
| 1700013570 | David Dwight Buckland | Psychiatry & Neurology | 950 E Bogard Rd, Suite 213, Wasilla, AK 99654-7184 | 2009-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003426784 | Colleen Maggie Newcity | Case Manager/Care Coordinator | 851 Westpoint Suite 310, Wasilla, AK 99654 | 2020-08-06 |
| 1659995884 | Amy M Lowe | Peer Specialist | 1363 W Spuce Ave, Wasilla, AK 99654 | 2020-06-03 |
| 1922648690 | Achieve Medical Alaska LLC | Clinic/Center | 1981 E Palmer, Suite 230, Wasilla, AK 99654 | 2020-01-10 |
| 1588205538 | Juan Carlos Garcia | Physician Assistant | 950 East Bogard Road, Suite 103, Wasilla, AK 99654 | 2019-10-01 |
| 1427610864 | Sharon Webb | Counselor | 705 S Knik Goose Bay Rd Suite K, Wasilla, AK 99654 | 2019-07-06 |
| 1306401864 | Logan Lee Cook | Peer Specialist | 2953 E Fairview Loop, Wasilla, AK 99654 | 2019-05-09 |
| 1053883595 | Moose Creek Medical Clinic LLC | Nurse Practitioner | 2341 S. Fern St., Suite 300, Wasilla, AK 99654 | 2018-12-21 |
| 1487124962 | Melissa A Stevens | Massage Therapist | 2201 W That Rd, Wasilla, AK 99654 | 2018-11-28 |
| 1609359561 | Audrey E Beers | Midwife | 2405 S. Knik Goose Bay Rd., Wasilla, AK 99654 | 2018-09-07 |
| 1093297418 | Karlee Janine Mccorry | Occupational Therapist | 613 S Knik-goose Bay Rd, Wasilla, AK 99654 | 2018-09-01 |
| Find all providers in zip 99654 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386966364 | Nourishing Direction Inc | Surgery | 1029 W 3rd Ave, Suite 510, Anchorage, AK 99501-1981 | 2010-02-18 |
| 1891741393 | Jana K Cole | Surgery | 2741 Debarr Rd Ste C215, Anchorage, AK 99508-2978 | 2006-05-26 |
| 1306018106 | Laurie J. Bleicher, M.d., LLC | Surgery | 3851 Piper St, Suite U-422, Anchorage, AK 99508-6904 | 2008-04-01 |
| 1720105034 | Gregory H Dostal Md PC | Surgery | 3225 Hospital Dr, #102, Juneau, AK 99801-7863 | 2007-03-23 |
| 1073577326 | Susan Jane Dean | Surgery | 2490 S Woodworth Loop, Suite 310, Palmer, AK 99645-7405 | 2006-04-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.