Kathleen Rita Gannon, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

03077 Issued in IA

Practice address

1810 SW White Birch Circle
Ste 111
Ankeny, IA 50023-7226

Phone

(515) 964-7115

Fax

(515) 964-7899

NPI assigned

May 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Ankeny Internal Medicine PC

  • Internal Medicine Physician
  • Ankeny, IA
  • NPI 1427137520

  Internal Medicine

  NPD (past)
• Floyd County Memorial Hospital Commission

  • Critical Access Hospital
  • Charles City, IA
  • NPI 1265402390
  NPD (past)
• North Iowa Mercy Clinics

  • Family Medicine Physician
  • Mason City, IA
  • NPI 1922118918
  NPD (past)
• Mercy Health Northwest Arkansas Communities

  • Endocrinology, Diabetes & Metabolism Physician
  • Rogers, AR
  • NPI 1770087371
  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1922066331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 LAKE DRIVE",
            "address_2": "STE 250",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502662504",
            "telephone_number": "515-875-9925",
            "fax_number": "515-875-9923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 SW WHITE BIRCH CIRCLE",
            "address_2": "STE 111",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500237226",
            "telephone_number": "515-964-7115",
            "fax_number": "515-964-7899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNON",
        "first_name": "KATHLEEN",
        "middle_name": "RITA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "T2006-010",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "03077",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IA",
            "license": "03077",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159949003",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9170589",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Greg Fuqua, LMHC
• Kaleigha Gainey, LISW
• Candice Gallego
• Kate Ganger, NP
• Joan Kathryn Gannon-Palmer, D.D.S.
• Mark Gardalen, PHARMD
• Alexander Jovanni Garrido, PT, DPT
• Stefanie Gatica, ARNP
• Clara Gaul
• Emily S Gavin, MD

• All providers in Ankeny, IA
• Internal Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; 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.