Gary Fannon, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

1 Hurley PLZ
Flint, MI 48503-5902

Phone

(810) 262-9683

Fax

(810) 760-0440

NPI assigned

Jun 12, 2012

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

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Physician Group PCGroup PAC ID 0648277830, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Legacy Physician Group, P.C.

  • Specialist
  • Lansing, MI
  • NPI 1801800719
  Medicare reassignment Care Compare group
• Hurley Medical Center

  • Physician Assistant
  • Flint, MI
  • NPI 1881620748
  Medicare reassignment NPD
• Ecs Central Michigan PC

  • Emergency Medicine Physician
  • Owosso, MI
  • NPI 1043711930
  Medicare reassignment
• Emergency Department Physicians, P.C.

  • Emergency Medicine Physician
  • Detroit, MI
  • NPI 1225083595
  Medicare reassignment
• Epmg of Michigan, P.C.

  • Emergency Medicine Physician
  • Livonia, MI
  • NPI 1386688992
  Medicare reassignment
• Ppsmg Urgent Medical Care, PLLC

  • Urgent Care Clinic/Center
  • Swartz Creek, MI
  • NPI 1750704680
  Medicare reassignment
• Hurley Medical Center

  • Plastic and Reconstructive Surgery Physician
  • Flint, MI
  • NPI 1689345761
  NPD
• Amd Urgent Care Fenton

  • Urgent Care Clinic/Center
  • Fenton, MI
  • NPI 1437807807
  NPD (past)
• Millennium Physicians Association, PLLC

  • Multi-Specialty Clinic/Center
  • The Woodlands, TX
  • NPI 1255397733
  NPD (past)

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1447512819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HURLEY PLZ",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485035902",
            "telephone_number": "810-262-9683",
            "fax_number": "810-760-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HURLEY PLZ",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485035902",
            "telephone_number": "810-262-9683",
            "fax_number": "810-760-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANNON",
        "first_name": "GARY",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-12",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Service Agency of Mid-Michigan
• Family Support Services for Mental Recovery
• Family Support Services for Mental Recovery
• Kathleen Fan
• Fangbin Sun
• Mona Mahmoud Farah-Qaimari, DNP, FNP-BC
• Laura Farah
• Jamal D. Farhan, M.D.
• Halimeh Farhat, PA-C
• Faris Chiropractic Health Services PC

• Medical Physician Assistant in Flint, MI
• Providers in Flint, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.