Alexandra Louise Gannon, M.D.

Primary specialty

Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X

License

0101275640 Issued in VA

Practice address

12011 Lee Jackson Memorial Highway
Suite 302
Fair Oaks, VA 22033

Phone

(703) 246-0500

Fax

(855) 473-0122

NPI assigned

Apr 20, 2015

Last updated

Jul 18, 2024By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Shady Grove Fertility Reproductive Science Center

  • Reproductive Endocrinology Physician
  • Rockville, MD
  • NPI 1891849832
  NPD (past)
• Shady Grove Reproductive Science Center PC

  dba SGFC Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Rockville, MD
  • NPI 1437232758
  NPD (past)

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

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1922495639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9600 BLACKWELL RD STE 500",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503783",
            "fax_number": "855-473-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12011 LEE JACKSON MEMORIAL HIGHWAY",
            "address_2": "SUITE 302",
            "city": "FAIR OAKS",
            "state": "VA",
            "postal_code": "22033",
            "telephone_number": "703-246-0500",
            "fax_number": "855-473-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNON",
        "first_name": "ALEXANDRA",
        "middle_name": "LOUISE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-20",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "VA",
            "license": "0101275640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Gehr, FNP-BC

• Reproductive Endocrinology Physician in Fair Oaks, VA
• Providers in Fair Oaks, VA by specialty
• Reproductive Endocrinology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.