Individual provider Active NPI

Bryan Cannon, MD

  • Pediatric Cardiology Physician
  • Rochester, MN
National Provider Identifier
1942380373
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
53291 Issued in MN
Practice address
200 1St St SW
Rochester, MN 55905-0001
Phone
(507) 284-3297
Fax
(507) 284-3968
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X 53291 MN
Pediatric Cardiology Physician 2080P0202X K1982 TX
Pediatric Cardiology Physician 2080P0202X 41451 IA
Pediatric Cardiology Physician 2080P0202X 55005 WI
Pediatric Cardiology Physician 2080P0202X 53291 MN Primary

Addresses

Primary practice location

200 1St St SW
Rochester, MN 55905-0001

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-3297

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MN, WI, ND4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20080610000413 TX Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 2163592619 Reassigns benefits to 1 organization
I20101013001232 MN Practitioner - Pediatric MedicinePractitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 2163592619 Reassigns benefits to 12 organizations
I20110207000558 WI Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 2163592619 Reassigns benefits to 2 organizations
I20120105000794 ND Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 2163592619 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Cardiovascular Disease (Cardiology)
Education
University of Texas Southwestern Medical School at Dallas, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Childrens Physician GroupGroup PAC ID 4385722081, 661 clinicians

Practice addresses (Care Compare)

6651 Main St
Houston, TX 77030-2351
Phone (832) 826-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
53291MNMDClinical Cardiac Electrophysiology Physician
41451IAMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Aug 1, 2017 Accepting new patients
Texas Children's Physician Group CurrentSince Jun 14, 2024 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Aug 1, 2017 Accepting new patients
Sanford Bismarck CurrentSince Mar 30, 2022 Accepting new patients
Winona Health Services CurrentSince Sep 1, 2015 Accepting new patients
Mayo Clinic Health System-Lake City CurrentSince Jul 1, 2017 Accepting new patients
Winneshiek Medical Center CurrentSince Oct 27, 2018 Accepting new patients
St. Alexius Medical Center CurrentSince Sep 12, 2015 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Sep 11, 2011 Accepting new patients
Mayo Clinic Health System-Lake City Current Accepting new patients
Mayo Clinic CurrentSince Aug 23, 2010 Accepting new patients
Mayo Clinic Current Accepting new patients
Mayo Clinic Health System-Fairmont CurrentSince Mar 11, 2013 Accepting new patients
Mayo Clinic Arizona CurrentSince Mar 7, 2020 Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Apr 3, 2017 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Feb 28, 2017 Accepting new patients
Sanford Bismarck CurrentSince Mar 30, 2022 Accepting new patients
Mayo Clinic Arizona CurrentSince Mar 7, 2020 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Feb 28, 2017 Accepting new patients
St Alexius Medical Center CurrentSince Sep 12, 2015 Accepting new patients
Mayo Clinic Health System-St James CurrentSince Jun 15, 2017 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Sep 11, 2011 Accepting new patients
Mayo Clinic CurrentSince Aug 23, 2010 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Past Accepting new patients

Locations (25 of 28)

901 Montgomery St
Decorah, IA 52101
Phone (319) 382-2911

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

800 Medical Center Dr
Fairmont, MN 56031
Phone (507) 238-8100

500 W Grant St
Lake City, MN 55041
Phone (651) 345-3321

114 Main St S
Mabel, MN 55954
Phone (507) 493-5115

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

701 Hewitt Blvd
Red Wing, MN 55066
Phone (507) 377-6285

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

1101 Moulton and Parsons Dr
Saint James, MN 56081
Phone (507) 375-3261

825 Mankato Ave
Winona, MN 55987
Phone (507) 454-4925

855 Mankato Ave
Winona, MN 55987
Phone (507) 454-3680

3318 N 14th St
Bismarck, ND 58503
Phone (701) 323-8300

310 N 10th St
Bismarck, ND 58501
Phone (701) 530-7500

2603 E Broadway Ave
Bismarck, ND 58501
Phone (701) 323-5222

900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300

8611 N Mopac Expy
Austin, TX 78759
Phone (713) 816-1250

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

1102 Bates Ave
Houston, TX 77030
Phone (832) 822-4556

101 W Expressway 83
McAllen, TX 78503
Phone (956) 661-9840

6651 Main St
Va Hospital, TX 77030
Phone (832) 826-3000

1501 Thompson St
Bloomer, WI 54724
Phone (715) 568-2000

733 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 838-3806

1400 Bellinger St
Eau Claire, WI 54703
Phone (715) 838-3311

800 West Ave S
La Crosse, WI 54601
Phone (608) 372-5951

2321 Stout Rd
Menomonie, WI 54751
Phone (715) 235-5531

Interoperability endpoints

  • Direct secure messaging: bcannon540336@prddirect.texaschildrens.org

Organizations & group practices 24

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.

View all 24

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1942380373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-3297",
            "fax_number": "507-284-3968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-3297",
            "fax_number": "507-284-3968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "BRYAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "MN",
            "license": "53291",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "TX",
            "license": "K1982",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "IA",
            "license": "41451",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "WI",
            "license": "55005",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MN",
            "license": "53291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.