GAGNON PLASTIC AND RECONSTRUCTIVE SURGERY (NPI# 1578928628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578928628 |
| Entity Type | Organization |
| Organization Name | GAGNON PLASTIC AND RECONSTRUCTIVE SURGERY |
| 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 | 2015-12-16 |
| Last Update Date | 2016-01-19 |
| Authorized Official Name | DR. ELLIOTT B GAGNON (OWNER) |
| Authorized Official Telephone | 7074078726 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208200000X | Plastic 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 |
| 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 |
| 1497900278 | Rebecca J. Moore | Dietitian, Registered | 950 E Bogard Rd, Suite 207, Wasilla, AK 99654-7184 | 2008-11-20 |
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| 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 |
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| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417070905 | Elliott B Gagnon | Plastic Surgery | 950 E Bogard Rd, Suite 209, Wasilla, AK 99654-7184 | 2007-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346418829 | Wandra K. Miles, Md, Pllc | Plastic Surgery | 3137 Tongass Ave, Ketchikan, AK 99901-5745 | 2008-02-18 |
| 1497949697 | William W Wennen Md Facs | Plastic Surgery | 575 Riverstone Way, Unit 1, Fairbanks, AK 99709-2939 | 2007-08-30 |
| 1861776791 | Mat-su Plastic Surgery LLC | Plastic Surgery | 2490 S Woodworth Loop, Suite 310, Palmer, AK 99645-7405 | 2011-10-11 |
| 1659515237 | Aurora Plastic Surgery, LLC | Plastic Surgery | 1919 Lathrop St, Fairbanks, AK 99701-5930 | 2009-04-27 |
| 1871738674 | Plastic Surgeons of Alaska, LLC | Plastic Surgery | 2741 Debarr Rd Ste C215, Anchorage, AK 99508-2978 | 2008-12-08 |
| 1821114448 | Gregory Henry Dostal | Plastic Surgery | 3225 Hospital Dr, #102, Juneau, AK 99801 | 2007-03-22 |
| 1962533018 | Michael Manuel,md,pc | Plastic Surgery | 2741 Debarr Rd, C-215, Anchorage, AK 99508-2953 | 2007-03-08 |
| 1649380767 | Daniel William Suver | Plastic Surgery | 2741 Debarr Rd, Suite C215 Plastic Surgeons of Alaska, Anchorage, AK 99508-2978 | 2006-08-30 |
| 1003831488 | Michael D Manuel | Plastic Surgery | 2741 Debarr Rd Ste C215, Anchorage, AK 99508-2978 | 2006-07-13 |
| 1750353108 | George E Siegfried | Plastic Surgery | 1200 Airport Heights Dr, #190, Anchorage, AK 99508-2943 | 2006-02-01 |
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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.