Patrick Kevin Canon, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

0427635 Issued in KS

Practice address

3155 N Union Blvd
Colorado Springs, CO 80907-8703

Phone

(719) 219-1312

Fax

(719) 635-3578

NPI assigned

Aug 23, 2005

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

Other identifiers 1

Other names 1

• Dr. P Kevin Canon Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308614400000",
    "number": "1467445726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3155 N UNION BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809078703",
            "telephone_number": "719-219-1312",
            "fax_number": "719-635-3578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3155 N UNION BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809078703",
            "telephone_number": "719-219-1312",
            "fax_number": "719-635-3578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANON",
        "first_name": "PATRICK",
        "middle_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2011-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "KS",
            "license": "0427635",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "112821",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00162955",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "P",
            "last_name": "CANON",
            "middle_name": "KEVIN",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Claire Cannon
• Eileen Laurie Cannon, P.T.
• Jeremy Cannon
• Laurelyn Dee Cannon, PH.D.
• Grace Canon
• Daniel Cantarini, P.T.
• Amy Cantor
• Brittany Cantore
• Bethany Cantrell, LPC
• Jennifer Dawn Cantrell, PHARMD

• Ophthalmology Physician in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Ophthalmology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; 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.