Amy E. Webb, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A64739 Issued in CA

Practice address

911 Oak Park Blvd
Suite 107
Pismo Beach, CA 93449-3405

Phone

(805) 474-8700

Fax

(805) 474-8466

NPI assigned

Jun 13, 2005

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

Other identifiers 4

Other names 1

• Dr. Amy E. Cannon Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Avalon Pediatrics, Inc.

  • Pediatrics Physician
  • Pismo Beach, CA
  • NPI 1386916138
  NPD
• Yucca Valley Urgent Care, Inc.

  dba Avalon Urgent Care

  • Urgent Care Clinic/Center
  • Yucca Valley, CA
  • NPI 1518381367
  NPD (past)

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1275538605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 OAK PARK BLVD",
            "address_2": "SUITE 107",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934493405",
            "telephone_number": "805-474-8700",
            "fax_number": "805-474-8466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 OAK PARK BLVD",
            "address_2": "SUITE 107",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934493405",
            "telephone_number": "805-474-8700",
            "fax_number": "805-474-8466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBB",
        "first_name": "AMY",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-13",
        "last_updated": "2012-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A64739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCN/FIRST HEALTH PIN",
            "identifier": "5622418",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA PIN",
            "identifier": "00A7647390",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A647390",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7598095",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "CANNON",
            "middle_name": "E.",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ventana Health and Medical Center
• Dale A Vonruden, M.D.
• John Andrew Wakeman, DDS
• Alice Wallack, MD
• Alison Watt, PA-C
• Marc W. Weise, M.D.
• Shonra Anne Weiss, NP
• Wendy Eve Weiss, DO
• Lucille Amelia Whitaker, 11434
• Kathleen Wilde, RN

• Pediatrics Physician in Pismo Beach, CA
• Providers in Pismo Beach, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2012; 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.