Michael L McGannon, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

C32614 Issued in CA

Practice address

75 Nielson St
Em Dept
Watsonville, CA 95076-2468

Phone

(831) 761-5613

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Emergency Medical Group

  • Emergency Medicine Physician
  • Watsonville, CA
  • NPI 1750395729
  NPD (past)
• Watsonville Emergency Medical Group

  • Emergency Medicine Physician
  • Watsonville, CA
  • NPI 1154571404
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236729600000",
    "number": "1235216755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 W MEMORIAL RD",
            "address_2": "SUITE 121",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731341785",
            "telephone_number": "405-751-4664",
            "fax_number": "405-749-4561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 NIELSON ST",
            "address_2": "EM DEPT",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950762468",
            "telephone_number": "831-761-5613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGANNON",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2009-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "C32614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235216755",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "C32614",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Renee McCabe, MSW
• Terra Bailey McCormick, OTR/L
• Anne-Marie Edith McDaniel, M.D.
• Clayton Richard McDaniel, MD
• Amy Kathleen McEntee, D.O.
• Rebecca Anne McGill
• Susana I McNeely, RN
• Krista Medina
• Myrna Jose Medina, DDS
• Daniel Mednoza Pacheco

• Emergency Medicine Physician in Watsonville, CA
• Providers in Watsonville, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2009; 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.