Individual provider Active NPI

Anthony W Gannon, M.D.

  • Pediatric Endocrinology Physician
  • Wilmington, DE
National Provider Identifier
1376754002
Registry record updated Jul 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
C1-0010871 Issued in DE
Practice address
1600 Rockland Rd
Division of Pediatric Endocrinology
Wilmington, DE 19803-3607
Phone
(302) 651-5965
Fax
(302) 651-4945
NPI assigned
May 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X C1-0010871 DE Primary

Addresses

Primary practice location

1600 Rockland Rd
Division of Pediatric Endocrinology
Wilmington, DE 19803-3607

Mailing address

1600 Rockland Rd
Division of Pediatric Endocrinology
Wilmington, DE 19803-3607
Phone (302) 651-5965

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, DE2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20141203001263 NJ Practitioner - EndocrinologyPractitioner - Pediatric Medicine 0446315246 Reassigns benefits to 1 organization
I20150305000774 DE Practitioner - Endocrinology 0446315246 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C1-0010871DEMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation CurrentSince Aug 4, 2015 Accepting new patients
The Nemours Foundation CurrentSince Aug 4, 2015 Accepting new patients
Christiana Care Health Services Inc CurrentSince Jan 1, 2015 Accepting new patients
Christiana Care Health Services, Inc Current Accepting new patients
Cooper Pediatric Specialists, PC CurrentSince Aug 1, 2014 Accepting new patients
Christiana Care Health Services Inc CurrentSince Jan 1, 2015 Accepting new patients
Newton Hospital, Inc. Past Accepting new patients
The Nemours Foundation Past Accepting new patients
Newton Hospital, Inc Past Accepting new patients

Locations

1600 Rockland Rd
Wilmington, DE 19803

3506 Kennett Pike
Wilmington, DE 19807
Phone (302) 661-3000

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

3 Cooper Plz
Rm 200
Camden, NJ 08103
Phone (609) 342-2001

Interoperability endpoints

  • Direct secure messaging: agannon49266@direct.nemours.org

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438300800000",
    "number": "1376754002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 ROCKLAND RD",
            "address_2": "DIVISION OF PEDIATRIC ENDOCRINOLOGY",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198033607",
            "telephone_number": "302-651-5965",
            "fax_number": "302-651-5419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 ROCKLAND RD",
            "address_2": "DIVISION OF PEDIATRIC ENDOCRINOLOGY",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198033607",
            "telephone_number": "302-651-5965",
            "fax_number": "302-651-4945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNON",
        "first_name": "ANTHONY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2015-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "DE",
            "license": "C1-0010871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.