NPIMap

Organization Active NPI

David Gannon, DPM, LLC

  • Podiatrist
  • Ocean View, DE
National Provider Identifier
1639501513
Registry record updated Aug 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E1-0000205 Issued in DE
Legal business name
DAVID GANNON, DPM, LLC
Practice address
96 Atlantic Ave
Unit #3
Ocean View, DE 19970-9103
Phone
(410) 629-0222
Fax
(410) 629-0225
NPI assigned
Aug 2, 2013
Last updated
Aug 2, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2013

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

Authorized official

Name
Dr. David Gannon, DPMNPI 1376521492
Title
Doctor/Owner
Phone
(410) 629-0222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E1-0000205 DE Primary

Addresses

Primary practice location

96 Atlantic Ave
Unit #3
Ocean View, DE 19970-9103

Mailing address

9956 N Main St
Suite #5
Berlin, MD 21811-1077
Phone (410) 629-0222

Other identifiers 2

IdentifierTypeStateIssuer
E1-0000205OtherDEDELAWARE LICENSE
1861415200MedicaidDE

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

96 Atlantic Ave
#3
Ocean View, DE 19970
Phone (410) 629-0222

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1375401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375401600000",
    "number": "1639501513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9956 N MAIN ST",
            "address_2": "SUITE #5",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218111077",
            "telephone_number": "410-629-0222",
            "fax_number": "410-629-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 ATLANTIC AVE",
            "address_2": "UNIT #3",
            "city": "OCEAN VIEW",
            "state": "DE",
            "postal_code": "199709103",
            "telephone_number": "410-629-0222",
            "fax_number": "410-629-0225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID GANNON, DPM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-02",
        "last_updated": "2013-08-02",
        "status": "A",
        "authorized_official_last_name": "GANNON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "410-629-0222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "DE",
            "license": "E1-0000205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELAWARE LICENSE",
            "identifier": "E1-0000205",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861415200",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean View, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2013; 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.