Active NPI
Jeremy Neal Gannon, CRNA
- Certified Registered Nurse Anesthetist
- Charleston, WV
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 110057
- Practice address
- 501 Morris St
Charleston, WV 25301-1326 - Phone
- (304) 388-5432
- NPI assigned
- Jul 12, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 110057 | WV | Primary |
Addresses
Primary practice location
501 Morris St
Charleston, WV 25301-1326
Mailing address
810 Lakeview Dr
Cross Lanes, WV 25313-1448
Phone (304) 543-9433
Other practice location 1
1400 Hospital Dr
Hurricane, WV 25526-9202
Phone (304) 720-8816
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1340 Hal Greer Blvd
Huntington, WV 25701-3804
Phone (304) 526-2000
Hospital & facility affiliations
- Cabell Huntington Hospital, Inc
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.94 of 100
- Quality
- 69.71
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110057 | WV | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Charleston Area Medical Center, Inc. | Current | Accepting new patients | |
| Charleston Area Medical Center Inc | Current | Accepting new patients | |
| Northstar Anesthesia of West Virginia, PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
3200 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-2550
501 Morris St
Charleston, WV 25301
Phone (304) 348-6293
1340 Hal Greer Blvd
Huntington, WV 25701
Phone (304) 399-2960
1400 Hospital Dr
Hurricane, WV 25526
Phone (304) 757-1700
Organizations & group practices 3
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.
-
- Anesthesiology Physician
- Irving, TX
- NPI 1821448150
Nurse Anesthetist, Certified Registered, WV
-
- General Acute Care Hospital
- Charleston, WV
- NPI 1124248752
-
- Multi-Specialty Clinic/Center
- Belpre, OH
- NPI 1588422547
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Huntington, WV
- NPI 1073518007
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780963200000",
"number": "1689246589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "810 LAKEVIEW DR",
"city": "CROSS LANES",
"state": "WV",
"postal_code": "253131448",
"telephone_number": "304-543-9433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 MORRIS ST",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253011326",
"telephone_number": "304-388-5432"
}
],
"practiceLocations": [
{
"address_1": "1400 Hospital Dr",
"address_purpose": "LOCATION",
"city": "Hurricane",
"state": "WV",
"postal_code": "255269202",
"country_code": "US",
"telephone_number": "304-720-8816",
"fax_number": "904-494-6467",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GANNON",
"first_name": "JEREMY",
"middle_name": "NEAL",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-07-12",
"last_updated": "2026-06-09",
"certification_date": "2026-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WV",
"license": "110057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.