Individual provider Active NPI

Steven Gannon, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Indianapolis, IN
National Provider Identifier
1265877195
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
01084292A Issued in IN
Practice address
8333 Naab Rd Ste 250
Indianapolis, IN 46260-1983
Phone
(317) 338-5100
NPI assigned
May 6, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R1753 TX
Internal Medicine Physician 207R00000X 01084292A IN
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 99099407A IN
Pulmonary Disease Physician 207RP1001X 99099407A IN
Pulmonary Disease Physician 207RP1001X 01084292A IN
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 01084292A IN Primary

Addresses

Primary practice location

8333 Naab Rd Ste 250
Indianapolis, IN 46260-1983

Mailing address

8333 Naab Rd Ste 250
Indianapolis, IN 46260-1983

Other practice location 1

300 University Blvd
Round Rock, TX 78665-1032
Phone (512) 509-0100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address steven.gannon.1@7598.direct.athenahealth.com St. Vincent Medical Group, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200812000411 IN Practitioner - Pulmonary Disease 6709020704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Wayne State University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

8330 Naab Rd
Suite 340
Indianapolis, IN 46260-2279
Phone (317) 415-6500

Hospital & facility affiliations

  • Ascension St Vincent Hospital Hospital, Indianapolis, IN, CCN 150084
  • St Vincent Heart Center Hospital, Carmel, IN, CCN 150153
  • Ascension St Vincent Carmel Hospital, Carmel, IN, CCN 150157
  • Ascension St Vincent Kokomo Hospital, Kokomo, IN, CCN 150010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01084292AINMDCritical Care Medicine (Internal Medicine) Physician
99099407AINMDPulmonary Disease Physician

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1367798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1265877195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8333 NAAB RD STE 250",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8333 NAAB RD STE 250",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601983",
            "telephone_number": "317-338-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 University Blvd",
            "address_purpose": "LOCATION",
            "city": "Round Rock",
            "state": "TX",
            "postal_code": "786651032",
            "country_code": "US",
            "telephone_number": "512-509-0100",
            "fax_number": "512-218-6330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANNON",
        "first_name": "STEVEN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-06",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "R1753",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01084292A",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IN",
            "license": "99099407A",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IN",
            "license": "99099407A",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IN",
            "license": "01084292A",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IN",
            "license": "01084292A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "steven.gannon.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St. Vincent Medical Group, Inc.",
            "address_1": "8333 Naab Rd Ste 250",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462601983",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.