David Cannon, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

DC00295 Issued in MI

Practice address

3200 S Airport Rd W
#146
Traverse City, MI 49684-8117

Phone

(231) 941-5440

Fax

(231) 941-0893

NPI assigned

Dec 15, 2005

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 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Ferris State College - College of Optometry, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nichols Optical IncGroup PAC ID 2466447966, 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Nichols Optical Inc

  • Optometrist
  • Traverse City, MI
  • NPI 1679558712
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311897600000",
    "number": "1487630133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 S AIRPORT RD W",
            "address_2": "#146",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848117",
            "telephone_number": "231-941-5440",
            "fax_number": "231-941-0893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 S AIRPORT RD W",
            "address_2": "#146",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848117",
            "telephone_number": "231-941-5440",
            "fax_number": "231-941-0893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "DAVID",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2011-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "DC00295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3278492",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria Cammarata, LMSW
• Frederick W Campbell III, M.D.
• Jeffrey Eric Campbell, M.S.AC, DIPL. AC
• John A Campbell, M.D.
• Callie Dee Campeau, LMT
• Capable at Home Specialists LLC
• Donald A. Caraccio, M. D.
• Lauren Cardella, DO
• Erika Lynn Cardinel-Solomonson, LMSW
• Cardiothoracic Surgeons

• Optometrist in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2011; 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.