David Pearce Fannon, MPAS, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA08166 Issued in TX

Practice address

800 E Dawson St
Tyler, TX 75701-2036

Phone

(903) 606-4262

NPI assigned

Feb 14, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dfannon237941@christushealth.direct-ci.net

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.

• Mother Frances Hospital Regional Health Care Center

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439

  TX

  Medicare reassignment NPD
• Mother Frances Hospital Jacksonville

  • Critical Access Hospital
  • Jacksonville, TX
  • NPI 1952306672

  TX

  Medicare reassignment
• Northeast Texas Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Longview, TX
  • NPI 1114607611

  TX

  Medicare reassignment
• Camino Real Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Livingston, TX
  • NPI 1992871966
  NPD (past)
• Texas Emergency Room Services PA

  • Emergency Medicine Physician
  • Lufkin, TX
  • NPI 1992843387
  NPD (past)

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

{
    "created_epoch": "1360800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1154660975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8198 WALNUT HILL LN",
            "address_2": "SUITE 2007",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314316",
            "telephone_number": "214-345-4733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E DAWSON ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012036",
            "telephone_number": "903-606-4262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8198 Walnut Hill Ln",
            "address_2": "Suite 2007",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752314316",
            "country_code": "US",
            "telephone_number": "214-345-4733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FANNON",
        "first_name": "DAVID",
        "middle_name": "PEARCE",
        "name_prefix": "Mr.",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-14",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA08166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCRR",
            "identifier": "P02592821",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCRR",
            "identifier": "P02592787",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Family Care Sitter Services
• Family First Pharmacy LP
• Wayne Bradshaw Fancher III, DPT, PT
• Fannin County Hospital Authority
• Paul M Fanning, MD
• Concepcion Fanous, APRN, FNP-C
• Elias I Fanous Jr., MD
• Christian Paul Fant, RD
• Osama Ali Faridi, DO
• Joy 'Jackie' Farmer, M.ED

• Medical Physician Assistant in Tyler, TX
• Providers in Tyler, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.