Active NPI
Lindsey Voncannon, M.D.
- Pediatrics Physician
- Buckley AFB, CO
National Provider Identifier
1578957882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD60762209
- Practice address
- 275 S Aspen St
Buckley AFB, CO 80011 - Phone
- (720) 847-7677
- NPI assigned
- Mar 25, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD60762209 | WA | Primary |
Addresses
Primary practice location
275 S Aspen St
Buckley AFB, CO 80011
Mailing address
275 S Aspen St
Buckley AFB, CO 80011-9562
Phone (720) 847-7677
Other names 1
- Lindsey Martin
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150916003598 | NC | Order and Referring Only - Pediatric Medicine | 5698082055 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD60762209 | WA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trojan Pediatrics, LLC | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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": "1427241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623628800000",
"number": "1578957882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "275 S ASPEN ST",
"city": "BUCKLEY AFB",
"state": "CO",
"postal_code": "800119562",
"telephone_number": "720-847-7677",
"fax_number": "720-847-7373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 S ASPEN ST",
"city": "BUCKLEY AFB",
"state": "CO",
"postal_code": "80011",
"telephone_number": "720-847-7677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VONCANNON",
"first_name": "LINDSEY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-25",
"last_updated": "2021-06-14",
"certification_date": "2021-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WA",
"license": "MD60762209",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LINDSEY",
"last_name": "MARTIN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Buckley AFB, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.