Active NPI
George Duggan Hannon, MD
- Anesthesiology Physician
- Salt Lake City, UT
National Provider Identifier
1093822983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 177450-1205
- Practice address
- 100 N Medical Dr
Salt Lake City, UT 84113-1103 - Phone
- (801) 993-9551
- Fax
- (801) 733-5872
- NPI assigned
- Aug 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 177450-1205 | UT | Primary |
Addresses
Primary practice location
100 N Medical Dr
Salt Lake City, UT 84113-1103
Mailing address
12623 E Guardsman Pass Rd
Brighton, UT 84121-9729
Phone (435) 615-1280
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 870280408HA1 | Other | UT | EDUCATORS MUTUAL |
| 832106 | Medicaid | AZ | |
| 28154 | Other | UT | PEHP |
| 416936 | Other | UT | DESERET MUTUAL |
| QM0000049521 | Other | UT | ALTIUS |
| 2373 | Other | UT | HEALTHY U |
| 107006884101 | Other | UT | IHC |
| 401765 | Medicaid | MT | |
| PR00872 | Other | UT | MOLINA |
| 2000040 | Other | UT | UNITED HEALTHCARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Surgical Suite | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Ambulatory Surgical Clinic/Center
- West Jordan, UT
- NPI 1508040221
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093822983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12623 E GUARDSMAN PASS RD",
"city": "BRIGHTON",
"state": "UT",
"postal_code": "841219729",
"telephone_number": "435-615-1280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 N MEDICAL DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841131103",
"telephone_number": "801-993-9551",
"fax_number": "801-733-5872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANNON",
"first_name": "GEORGE",
"middle_name": "DUGGAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "UT",
"license": "177450-1205",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EDUCATORS MUTUAL",
"identifier": "870280408HA1",
"state": "UT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "832106",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PEHP",
"identifier": "28154",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DESERET MUTUAL",
"identifier": "416936",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALTIUS",
"identifier": "QM0000049521",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHY U",
"identifier": "2373",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IHC",
"identifier": "107006884101",
"state": "UT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "401765",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MOLINA",
"identifier": "PR00872",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "2000040",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.