J. David Bannon MD PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

136663 Issued in NY

Legal business name

J. DAVID BANNON MD PC

Doing business as

Bannon Orthopaedics & Sports Medicine

Practice address

543 Bay Rd
Queensbury, NY 12804-1441

Phone

(518) 761-2663

Fax

(518) 761-6831

NPI assigned

Jul 11, 2006

Organization subpart

No

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

Authorized official

Name

Dr. J David Bannon, MD

Title

President

Phone

(518) 761-2663

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• BANNON ORTHOPAEDICS & SPORTS MEDICINE Doing business as

Practitioners 1

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

• John David Bannon, MD,FACS

  • Specialist
  • Queensbury, NY
  • NPI 1396718201
  NPD (past)

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780618983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "543 BAY RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128041441",
            "telephone_number": "518-761-2663",
            "fax_number": "518-761-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "543 BAY RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128041441",
            "telephone_number": "518-761-2663",
            "fax_number": "518-761-6831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. DAVID BANNON MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BANNON",
        "authorized_official_first_name": "J",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "518-761-2663",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "136663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00832751",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BANNON ORTHOPAEDICS & SPORTS MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Innova Physical Therapy, PLLC
• Jennifer Islas
• Erik D Istre, MD
• Demi Iverson-Searer
• Vanessa R Ives, LCSW-R
• Elizabeth Jachim, MS CCC-SLP
• Erinn Jacobi, OTR/L
• Holly Jafarzade, DDS
• Emily Morgan James, RN
• Regina Jameson, AUD

• Specialist in Queensbury, NY
• Providers in Queensbury, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.