Mary Jo Cannon MD

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

License

D28907 Issued in MD

Legal business name

MARY JO CANNON MD

Practice address

20909 Sunnyacres Rd
Gaithersburg, MD 20882-1248

Phone

(240) 683-0015

NPI assigned

Jul 7, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Mary Jo Cannon, M.D.

Title

Practitioner

Phone

(240) 330-2430

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Jo Cannon, MD

  • Addiction Medicine (Family Medicine) Physician
  • Gaithersburg, MD
  • NPI 1619216835

  Adult Day Care

  NPD (past)

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

{
    "created_epoch": "1278460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360195200000",
    "number": "1942512942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20909 SUNNYACRES RD",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208821248",
            "telephone_number": "240-683-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20909 SUNNYACRES RD",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208821248",
            "telephone_number": "240-683-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY JO CANNON MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-07",
        "last_updated": "2013-02-07",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "PRACTITIONER",
        "authorized_official_telephone_number": "240-330-2430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "MD",
            "license": "D28907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William J Martone, M.D.
• Teresa Martucci, LCSW-C
• Nicole Martyn
• Poonam H Maru, DO, FACP
• Jordan Marville
• Maryland Behavioral Medicine
• Maryland Center for Familiy Guidance
• Maryland CVS Pharmacy LLC
• Maryland CVS Pharmacy LLC
• Maryland CVS Pharmacy, L.L.C.

• Adult Day Care Clinic/Center in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Adult Day Care Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; 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.