Cannon Chiropractic

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

CHIA-1580 Issued in ID

Legal business name

CANNON CHIROPRACTIC

Practice address

2052 Jennie Lee Dr
Suite 4
Idaho Falls, ID 83404-7047

Phone

(208) 557-1880

Fax

(208) 874-4273

NPI assigned

Jun 24, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Timothy W Cannon, D.C., M.S.NPI 1952722290

Title

Chiropractic Physician, Owner

Phone

(208) 557-1880

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Timothy Wade Cannon, D.C.

  • Chiropractor
  • Ammon, ID
  • NPI 1952722290
  NPD Authorized official

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403568000000",
    "number": "1164837647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2052 JENNIE LEE DR",
            "address_2": "SUITE 4",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047047",
            "telephone_number": "208-557-1880",
            "fax_number": "208-874-4273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2052 JENNIE LEE DR",
            "address_2": "SUITE 4",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047047",
            "telephone_number": "208-557-1880",
            "fax_number": "208-874-4273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANNON CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-24",
        "last_updated": "2014-06-24",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN, OWNER",
        "authorized_official_telephone_number": "208-557-1880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C., M.S."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "ID",
            "license": "CHIA-1580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Austin Jay Campbell, PA-C
• Christiane Cay Campbell, LMSW
• Pamela Jonel Campbell, LMSW
• Rena Campbell, PHARMD
• Carlene M Canfield, CRNA
• Christopher M Cannon, DMD
• Peter M Cannon, M.D.
• Richard Cannon, MD
• Aaron Mark Capener, DMD
• Mark Lee Capener, M.D.

• Primary Care Clinic/Center in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Primary Care Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.