Individual provider Active NPI

David W Gannon, MD

  • Family Medicine Physician
  • Chandler, AZ
National Provider Identifier
1477534816
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
16284 Issued in AZ
Practice address
1455 W Chandler Blvd
Chandler, AZ 85224-6197
Phone
(480) 899-2900
Fax
(480) 899-0681
NPI assigned
Nov 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 16284 AZ Primary

Addresses

Primary practice location

1455 W Chandler Blvd
Chandler, AZ 85224-6197

Mailing address

1455 W Chandler Blvd
Chandler, AZ 85224-6197
Phone (480) 899-2900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040701001585 AZ Practitioner - Family Practice 0143215269 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16284AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sjhmc Physician Services CurrentSince Jan 1, 2004 Accepting new patients
St. Joseph'S Hospital and Medical Center CurrentSince Aug 30, 2020 Accepting new patients
East Valley Family Physicians PLC CurrentSince Jan 1, 1984 Accepting new patients

Locations

1455 W Chandler Blvd
Ste A4
Chandler, AZ 85224
Phone (480) 899-2900

1455 W Chandler Blvd
Bldg A
Chandler, AZ 85224
Phone (480) 899-2900

1455 W Chandler Blvd
Chandler, AZ 85224
Phone (480) 899-2900

2927 N 7th Ave
Phoenix, AZ 85013
Phone (602) 406-3153

500 W Thomas Rd
Ste 680
Phoenix, AZ 85013
Phone (602) 406-6017

File 56765
Los Angeles, CA 90074

Organizations & group practices 3

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": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1477534816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 W CHANDLER BLVD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246197",
            "telephone_number": "480-899-2900",
            "fax_number": "480-899-0681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 W CHANDLER BLVD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246197",
            "telephone_number": "480-899-2900",
            "fax_number": "480-899-0681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNON",
        "first_name": "DAVID",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-11",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "16284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.