Amy Gannon

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

201 Middlebridge Rd
Wakefield, RI 02879-7105

Phone

(860) 817-6905

NPI assigned

Jan 31, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1485820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1639616477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 MIDDLEBRIDGE RD",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028797105",
            "telephone_number": "860-817-6905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 MIDDLEBRIDGE RD",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028797105",
            "telephone_number": "860-817-6905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNON",
        "first_name": "AMY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-31",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J Riley Fowler Jr., APRN CNP
• Olivia Evangeline Frangos, ATC
• Frank a. Dequattro, DMD
• Holly B. Fuscaldo, MSW, LCSW
• Galilee Mission, Inc.
• Lillian Merrill Gates, OTR/L
• Shennel Martina Gelin, MD
• Beverly J Genader, APRN
• Douglas Bruce Genereux, PA-C
• Bertram St Cyr Linard Gibbes, PHD PSYCHOLOGIST

• Community Health Worker in Wakefield, RI
• Providers in Wakefield, RI by specialty
• Community Health Worker in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; 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.