Active NPI
Danielle M Cannon, NP
- Family Nurse Practitioner
- Indianapolis, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71014124A
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300098798 | Medicaid | IN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 28235257A | IN | MD | Family Nurse Practitioner |
| 71014124A | IN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Pediatric Associates, Inc. | Current | 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.
-
- Pediatrics Physician
- Indianapolis, IN
- NPI 1457396541
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.