Doctor Cannon PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

DOCTOR CANNON PLLC

Doing business as

Cannon EyeCare

Practice address

2602 NE University Village St
Suite B (at Market Optical)
Seattle, WA 98105-5023

Phone

(206) 522-9323

Fax

(206) 525-3841

NPI assigned

Apr 17, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Miranda Cannon, O.D.NPI 1104130871

Title

Member

Phone

(206) 714-8606

Specialties & licenses 1

Addresses

Other names 2

• Cannon EyeCare Doing business as
• Cannon EyeCare (at Market Optical) Other name

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Doctor Cannon PLLC

  dba Cannon EyeCare (at Pike Place's Market Optical)

  • Optometrist
  • Seattle, WA
  • NPI 1023777067

  O20160203002226

  Same enrollment

Tax ID family

Doctor Cannon PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Doctor Cannon PLLC

  dba Cannon EyeCare (at Pike Place's Market Optical)

  • Optometrist
  • Seattle, WA
  • NPI 1023777067
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Doctor Cannon PLLC

  dba Cannon EyeCare (at Pike Place's Market Optical)

  • Optometrist
  • Seattle, WA
  • NPI 1023777067
  NPPES parent name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Miranda Murray Cannon, O.D.

  • Optometrist
  • Seattle, WA
  • NPI 1104130871
  Medicare reassignment Care Compare group NPD Authorized official
• Mark J Cannon, OD

  • Optometrist
  • Seattle, WA
  • NPI 1407162936
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1397692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663632000000",
    "number": "1578983532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2602 NE UNIVERSITY VILLAGE ST",
            "address_2": "SUITE B (AT MARKET OPTICAL)",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981055023",
            "telephone_number": "206-522-9323",
            "fax_number": "206-525-3841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2602 NE UNIVERSITY VILLAGE ST",
            "address_2": "SUITE B (AT MARKET OPTICAL)",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981055023",
            "telephone_number": "206-522-9323",
            "fax_number": "206-525-3841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTOR CANNON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-17",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "MIRANDA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "206-714-8606",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cannon EyeCare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cannon EyeCare (at Market Optical)",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Amy Bilyk Dock, DPT
• Donna Mae Dockter, RPH
• Alicia Dixon Docter, MS, RD
• Clara Nele Doctolero, PSY.D
• Doctor Cannon PLLC (Cannon EyeCare (at Pike Place's Market Optical))
• Christopher Michael Dodd, MD
• Danny D. Dodd, LMHC
• Nailah Dodd, CNM
• Simran Dodd, PHARMD
• Sally Dodds, CO 60234266

• Optometrist in Seattle, WA
• Providers in Seattle, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.