Lillian Deann Cannon, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

2241 Farnum St Ste 105
Casper, WY 82609-4108

Phone

(307) 295-7288

Fax

(307) 333-1352

NPI assigned

Oct 3, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WY

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health Center of Central Wyoming IncGroup PAC ID 3375454705, 27 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Community Health Center of Central Wyoming, Inc.

  • Federally Qualified Health Center (FQHC)
  • Casper, WY
  • NPI 1447480561

  WY

  Medicare reassignment Care Compare group NPD (past)
• Vitality Medical Solutions LLC

  • Physician Assistant
  • Casper, WY
  • NPI 1336976281
  NPD Authorized official
• University of Wyoming

  • Federally Qualified Health Center (FQHC)
  • Cheyenne, WY
  • NPI 1770681439

  WY

  Medicare reassignment
• Community Health Center of Central Wyoming Inc

  • Federally Qualified Health Center (FQHC)
  • Riverton, WY
  • NPI 1275810160
  NPD
• University of Wyoming

  • Federally Qualified Health Center (FQHC)
  • Casper, WY
  • NPI 1558657650
  NPD
• University of Wyoming

  • Federally Qualified Health Center (FQHC)
  • Laramie, WY
  • NPI 1639617061
  NPD (past)

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

{
    "created_epoch": "1349222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1174875991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2241 FARNUM ST STE 105",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826094108",
            "telephone_number": "307-295-7288",
            "fax_number": "307-333-1352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2241 FARNUM ST STE 105",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826094108",
            "telephone_number": "307-295-7288",
            "fax_number": "307-333-1352"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5000 Blackmore Rd",
            "address_purpose": "LOCATION",
            "city": "Casper",
            "state": "WY",
            "postal_code": "826093345",
            "country_code": "US",
            "telephone_number": "307-233-6000",
            "fax_number": "307-233-6089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANNON",
        "first_name": "LILLIAN",
        "middle_name": "DEANN",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-03",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ricardo Augusto Caldas, DO
• Herlly Yohanna Camacho Bastidas, ARNP
• Amanda Campbell
• Charlene L Canada, MRC CRC
• Candid Wyoming, P.C.
• Lona Cantine, R.N.
• Savannah Marie Cardenas, FNP, DNP
• James T. Carder, RPH
• Care Partners of Wyoming
• Care Wy LLC

• Physician Assistant in Casper, WY
• Providers in Casper, WY by specialty
• Physician Assistant in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.