Individual provider Active NPI

Danielle M Cannon, NP

  • Family Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1801576962
Registry record updated Dec 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71014124A Issued in IN
Practice address
705 Riley Hospital Dr
Indianapolis, IN 46202-5109
Phone
(317) 948-7208
Fax
(317) 944-5791
NPI assigned
Jul 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 28235257A IN
Family Nurse Practitioner 363LF0000X 71014124A IN Primary

Addresses

Primary practice location

705 Riley Hospital Dr
Indianapolis, IN 46202-5109

Mailing address

PO Box 778912
Chicago, IL 60677-8912
Phone (317) 777-6435

Other identifiers 1

IdentifierTypeStateIssuer
300098798MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28235257AINMDFamily Nurse Practitioner
71014124AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatric Associates, Inc. CurrentSince Nov 10, 2024 Accepting new patients
Iu Health Medical Group, LLC Family Past Accepting new patients

Locations

4935 W Arlington Rd
Bloomington, IN 47404
Phone (812) 353-3743

11725 Illinois St
Ste 450
Carmel, IN 46032
Phone (317) 688-5700

11590 N Meridian St
Ste 300
Carmel, IN 46032
Phone (317) 944-8906

11700 N Meridian St
Carmel, IN 46032
Phone (317) 688-2000

11725 Illinois St
Ste 520
Carmel, IN 46032
Phone (317) 688-5189

13100 E 136th St
Fishers, IN 46037
Phone (317) 678-2000

415 E Cook Rd
Ste 300
Fort Wayne, IN 46825
Phone (317) 944-6201

575 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 944-3966

705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779

8111 S Emerson Ave
Indianapolis, IN 46237
Phone (317) 528-5261

7150 Clearvista Dr
Indianapolis, IN 46256
Phone (317) 355-5041

1555 Commerce Dr
Logansport, IN 46947
Phone (219) 753-0404

2325 S Miller St
Shelbyville, IN 46176
Phone (317) 392-3287

211 N Eddy St
South Bend, IN 46617
Phone (574) 237-9331

Organizations & group practices 2

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": "1690156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734998400000",
    "number": "1801576962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 778912",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606778912",
            "telephone_number": "317-777-6435",
            "fax_number": "317-777-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 RILEY HOSPITAL DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025109",
            "telephone_number": "317-948-7208",
            "fax_number": "317-944-5791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "DANIELLE",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-24",
        "last_updated": "2024-12-24",
        "certification_date": "2024-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28235257A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71014124A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300098798",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2024; 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.