Individual provider Active NPI

Donald Wayne Cannon, D.C.

  • Chiropractor
  • Grand Junction, CO
National Provider Identifier
1730399247
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1287 Issued in CO
Practice address
2472 F Road
Unit 6
Grand Junction, CO 81505-1205
Phone
(970) 242-0280
Fax
(970) 242-6463
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1287 CO Primary

Addresses

Primary practice location

2472 F Road
Unit 6
Grand Junction, CO 81505-1205

Mailing address

2472 F Road
Unit 6
Grand Junction, CO 81505
Phone (970) 242-0280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050913000565 CO Practitioner - Chiropractic 1850324658 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
1287COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Absolute Chiropractic P.C. Chiropractor CurrentSince Nov 16, 2011 Accepting new patients

Locations

2472 Patterson Rd
Unit 6
Grand Junction, CO 81505
Phone (970) 242-0280

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730399247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2472 F ROAD",
            "address_2": "UNIT 6",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "81505",
            "telephone_number": "970-242-0280",
            "fax_number": "970-242-6463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2472 F ROAD",
            "address_2": "UNIT 6",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815051205",
            "telephone_number": "970-242-0280",
            "fax_number": "970-242-6463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "DONALD",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "1287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.