Gannon Parker, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0008509 Issued in CO

Practice address

10101 Ridgegate Pkwy
Lone Tree, CO 80124-5522

Phone

(720) 255-1000

NPI assigned

Jul 24, 2022

Last updated

Apr 29, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Healthone Clinic Services Orthopedic Specialists LLC

  • Orthopaedic Surgery Physician
  • Westminster, CO
  • NPI 1245556091
  Medicare reassignment

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

{
    "created_epoch": "1658620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1316672215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10101 RIDGEGATE PKWY",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801245522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 RIDGEGATE PKWY",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801245522",
            "telephone_number": "720-255-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "GANNON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-24",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "0008509",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Park Meadows Outpatient Surgery, LLC
• Park Meadows Vision Associates PLLC
• Park Ridge Surgery Center, LLC (Park Ridge Surgery Center)
• Charles Keyu Park, M.D.
• Hy Gia Young Park, MPH, MS, MD
• Parkridge Endodontics, PC
• Parkridge Vision Specialists, PC
• Stephanie Parks
• Parry Endodontics (Lone Tree Endodontics)
• Susan L Pash-Lohr, DO

• Physician Assistant in Lone Tree, CO
• Providers in Lone Tree, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.