Timothy Wade Cannon, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA-1580 Issued in ID

Practice address

611 Ensign Dr
Ammon, ID 83406-4777

Phone

(208) 557-1880

NPI assigned

Jan 3, 2014

Last updated

Feb 9, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in OR

Enrollment records 1

Specialty

Chiropractic

Education

Western States College of Chiropractic, 2013

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Umpqua Chiropractic PC

  • Chiropractor
  • Roseburg, OR
  • NPI 1124644216
  Medicare reassignment NPD
• Cannon Chiropractic

  • Primary Care Clinic/Center
  • Idaho Falls, ID
  • NPI 1164837647
  NPD Authorized official

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

{
    "created_epoch": "1388707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486598400000",
    "number": "1952722290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 ENSIGN DR",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834064777",
            "telephone_number": "208-557-1880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 ENSIGN DR",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834064777",
            "telephone_number": "208-557-1880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "TIMOTHY",
        "middle_name": "WADE",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-03",
        "last_updated": "2017-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elane Burgess, RC-CPSS
• Lalanni Burnell, CPSS
• David Dean Buys, PA-C
• Victoria Caldwell, BS
• John-Charles Cannon, BS
• Carol Klett Vance MD, Inc.
• Carolee M Cutler Peck MD MPH Oprs PLLC (Cutler Peck Oculofacial Plastic Surgery)
• Carriage House Obstetrics and Gyncecology, LLC
• Cassy Champion, BS
• Siu Ling CHI

• Chiropractor in Ammon, ID
• Providers in Ammon, ID by specialty
• Chiropractor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.