Kathryn E Gannon-Loew

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

61745-20 Issued in WI

Practice address

2880 University Ave
Madison, WI 53705-3644

Phone

(608) 263-6421

Fax

(608) 263-6547

NPI assigned

Apr 25, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Kathryn Gannon Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• University of Wisconsin Medical Foundation, Inc

  • Multi-Specialty Clinic/Center
  • Middleton, WI
  • NPI 1598784555
  Medicare reassignment NPD
• University of Wisconsin Medical Foundation, Inc

  • Health Educator
  • Madison, WI
  • NPI 1487414082

  Multi-Specialty

  NPD
• University of Wisconsin Medical Foundation Inc

  • Durable Medical Equipment & Medical Supplies
  • Cross Plains, WI
  • NPI 1174583363
  NPD (past)

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656806400000",
    "number": "1801154000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531",
            "telephone_number": "608-829-5485",
            "fax_number": "608-263-6547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 UNIVERSITY AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537053644",
            "telephone_number": "608-263-6421",
            "fax_number": "608-263-6547"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Childrens Dr",
            "address_2": "Timken Hall TH3A",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432052664",
            "country_code": "US",
            "telephone_number": "614-722-2458",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3333 Burnet Avenue",
            "address_2": "ML 4000",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452293026",
            "country_code": "US",
            "telephone_number": "513-636-4681",
            "fax_number": "513-636-7844",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 E Campus Mall",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537151365",
            "country_code": "US",
            "telephone_number": "608-265-5600",
            "fax_number": "608-263-6884",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "540 N 16th St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532332160",
            "country_code": "US",
            "telephone_number": "414-288-7184",
            "fax_number": "414-288-1664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANNON-LOEW",
        "first_name": "KATHRYN",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-25",
        "last_updated": "2022-07-03",
        "certification_date": "2022-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "OH",
            "license": "35.126176",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "WI",
            "license": "61745-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0133627",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgannonloew29183@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "2880 University Ave",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537053644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "GANNON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brian Harrison Gander, M.D.
• Jorja Gander, PHARMD
• Rebecca Janelle Gander, DMD
• Mariana Gandolfo Bustamante, MS, RDN, CD
• Melissa A. Gannage, M.D.
• Samantha Gannon, OTR
• Laura A Ganske, PT, DPT
• Yingyu Gao, MD
• Paul Gapinski
• Laura Anne Garbacz, PHARMD

• Pediatric Adolescent Medicine Physician in Madison, WI
• Providers in Madison, WI by specialty
• Pediatric Adolescent Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.