John David Bannon, MD,FACS

Primary specialty

SpecialistTaxonomy code 174400000X

License

136663 Issued in NY

Practice address

543 Bay Rd
Queensbury, NY 12804-1441

Phone

(518) 761-2663

Fax

(518) 761-6831

NPI assigned

Feb 10, 2006

Last updated

Mar 7, 2023By 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 1

Addresses

Other identifiers 2

Other names 1

• Dr. J. David Bannon Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• J. David Bannon MD PC

  dba Bannon Orthopaedics & Sports Medicine

  • Specialist
  • Queensbury, NY
  • NPI 1780618983
  NPD (past)

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1396718201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "543 BAY RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128041441",
            "telephone_number": "518-761-2663",
            "fax_number": "518-761-6831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "543 BAY RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128041441",
            "telephone_number": "518-761-2663",
            "fax_number": "518-761-6831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNON",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD,FACS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "136663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00832751",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "136663",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "J.",
            "last_name": "BANNON",
            "middle_name": "DAVID",
            "prefix": "DR.",
            "credential": "MD,FACS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Brooke Bailey
• Kelly A Bailey, FNP-C
• Kyle Bailey, PT, DPT
• Amy Marie Baker, MSW
• Jenelle Baker, LMHC
• Logan Barber
• Teresa Lynn Barber
• Olivia Bardin
• Colleen Baroudi
• Shalini Barrow

• Specialist in Queensbury, NY
• Providers in Queensbury, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.