Kimberly Parker Gannon, MD, PHD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

C1-0011514 Issued in DE

Practice address

4755 Ogletown Stanton Rd
Suite 1070
Newark, DE 19718-2200

Phone

(302) 733-5982

NPI assigned

May 19, 2011

Last updated

Jun 17, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in DE, MD2 enrollments

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 2

Specialty

Neurology

Education

University of Mississippi School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Union Hospital of Cecil CountyGroup PAC ID 6901719822, 281 clinicians

Christiana Care Health Services IncGroup PAC ID 9739097569, shared by 25 NPIs, 1,480 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christiana Hospital Hospital, Newark, DE, CCN 080001

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Union Hospital of Cecil County

  • Internal Medicine Physician
  • Elkton, MD
  • NPI 1124067848
  Medicare reassignment Care Compare group NPD
• Christiana Care Health Services Inc

  dba CCHS Hospitalist Partners

  • Hospitalist Physician
  • Newark, DE
  • NPI 1245474329

  Internal Medicine

  Medicare reassignment NPD
• Christiana Care Health Services Inc

  dba CCHS Neurology Specialists

  • Neurology Physician
  • Newark, DE
  • NPI 1457593949
  Medicare reassignment NPD
• Christiana Care Health Services Inc

  dba CCHS Interventional Radiology

  • Vascular & Interventional Radiology Physician
  • Wilmington, DE
  • NPI 1679727028

  Neurology

  Medicare reassignment NPD
• Christiana Care Health Services, Inc

  dba CCHS Pmri

  • Endocrinology, Diabetes & Metabolism Physician
  • Wilmington, DE
  • NPI 1770568107
  Medicare reassignment NPD
• Christiana Care Health Services, Inc

  dba CCHS Neurology

  • Neurology Physician
  • Newark, DE
  • NPI 1104896596
  NPD
• Christiana Care Health Services Inc

  dba CCHS Concord - Neurology

  • Neurology Physician
  • Chadds Ford, PA
  • NPI 1881228484
  NPD
• Union Hospital of Cecil County

  • Speech-Language Pathologist
  • Elkton, MD
  • NPI 1033865993
  NPD
• Christiana Care Health Services, Inc

  dba CCHS Satellite Offices

  • Family Medicine Physician
  • Hockessin, DE
  • NPI 1134104565

  Internal Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Christiana Care Health Services, Inc.

  dba Christiana Care

  • General Acute Care Hospital
  • Wilmington, DE
  • NPI 1134194038
  Care Compare affiliation

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

{
    "created_epoch": "1305763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466121600000",
    "number": "1831482165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HYGEIA DR",
            "address_2": "SUITE 2300",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON RD",
            "address_2": "SUITE 1070",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197182200",
            "telephone_number": "302-733-5982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNON",
        "first_name": "KIMBERLY",
        "middle_name": "PARKER",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-19",
        "last_updated": "2016-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT199438",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT199438",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "MT199438",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "DE",
            "license": "C1-0011514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Gandolfo
• Timothy Ganfield, D.M.D.
• Angelica Christine Gangemi-Hanninen, MD
• Laura Macdermott Gangloff, MA,CCC-SLP
• Alexis Kay Gannon
• Osominomo Garba
• Alejandro Garces Descovich, MD
• Cedrick James Lim Garcia, PA-C
• Tiffany Kathleen Garcia, D.C.
• Timothy J Gardner, MD

• Neurology Physician in Newark, DE
• Providers in Newark, DE by specialty
• Neurology Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.