DR. DAVID GANNON (NPI# 1376521492) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376521492 |
| Entity Type | Individual |
| Full Name | DR. DAVID GANNON |
| Credential | DPM |
| Practice Address |
9956 N Main St Suite #5 Berlin MD 21811-1077 |
| Practice Telephone | 4106290222 |
| Practice Fax Number | 4106290225 |
| Mailing Telephone | 4106290222 |
| Mailing Fax Number | 4106290225 |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2019-04-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213E00000X | Podiatrist | E1-0000205 | DE | Podiatric Medicine & Surgery Service Providers |
| Y | 213E00000X | Podiatrist | 01311 | MD | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 3494004-00 | 05 | |
| DE | DME | 6031730002 | 01 |
| DE | STATE LICENSE | E1-0000205 | 01 |
| MD | RAIL ROAD MEDICARE - INDIVIDUAL PTAN | P00639639 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548270952 | David John Gannon | Psychologist | 4572 Dressler Rd Nw, Canton, OH 44718-2546 | 2006-08-08 |
| 1518966472 | David P Gannon Jr. | Anesthesiology | 68 N Main St, Carver, MA 02330-1128 | 2005-07-21 |
| 1982707204 | David Edward Gannon | Internal Medicine | 988102 Nebraska Medical Center, Omaha, NE 68198-8102 | 2006-09-06 |
| 1003886128 | David L Gannon | Family Medicine | 2550 24th St, Rock Island, IL 61201-5304 | 2006-01-23 |
| 1477534816 | David W Gannon | Family Medicine | 1455 W Chandler Blvd, Chandler, AZ 85224-6197 | 2005-11-11 |
| Street Address |
9956 N MAIN ST SUITE #5 |
| City | BERLIN |
| State | MD |
| Zip Code | 21811-1077 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285171199 | Three Lower Counties Community Services, Inc. | Clinic/Center | 9956 N Main St, Unit# 2, Berlin, MD 21811-1077 | 2017-01-30 |
| 1023413317 | Sarah Colleen Kernan | Chiropractor | 9956 N Main St, Suite 4, Berlin, MD 21811-1077 | 2014-10-29 |
| 1720408610 | Amanda G Buckley | Dietitian, Registered | 9956 N Main St, Suite 2, Berlin, MD 21811-1077 | 2014-04-18 |
| 1558593814 | Amy Miller Gehrig | Dietitian, Registered | 9956 N Main St, Unit 2, Berlin, MD 21811-1077 | 2009-08-19 |
| 1174795124 | Optimal Health Chiropractic P. C. | Chiropractor | 9956 N Main St, Suite 4, Berlin, MD 21811-1077 | 2008-03-31 |
| 1710171236 | Jeffery Charles Michael | Chiropractor | 9956 N Main St, Suite 4, Berlin, MD 21811-1077 | 2007-08-28 |
| 1861415200 | David Gannon Dpm LLC | Podiatrist | 9956 N Main St, Suite #5, Berlin, MD 21811-1077 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366912909 | Kathleen Cathell | Speech-Language Pathologist | 11187 Racetrack Rd, Berlin, MD 21811 | 2018-11-27 |
| 1033613336 | Kimberly Rose Richardson | Registered Nurse | Atlantic General Hospital, 9733 Healthway Dr, Berlin, MD 21811 | 2018-03-21 |
| 1780108514 | Jayme Sroka Mahoney | Marriage & Family Therapist | 124 N. Main St. Ste. C, Berlin, MD 21811 | 2017-08-02 |
| 1013332543 | Ray Charles Lockamy Jr. | Behavior Technician | 10514 Racetrack Rd Ste G, Berlin, MD 21811 | 2014-02-20 |
| 1972845121 | Timothy Pearson | Dermatology | 9948 N. Main St., Berlin, MD 21811 | 2013-03-25 |
| 1710248315 | Jaime Farrell Coates | Counselor | 378 Schooner Ln, Berlin, MD 21811 | 2012-05-31 |
| 1902185697 | Lee Ahlstrom | Pharmacist | 11307 Manklin Creek Rd, Berlin, MD 21811 | 2011-08-11 |
| 1780987677 | Worcester County Health Department | Public Health or Welfare | 107 Williams Street, Worcester County Health Department Dental Center, Berlin, MD 21811 | 2010-12-15 |
| 1942511563 | Corey Lee Smith | Dentist | 11204 Racetrack Rd Ste 102, Berlin, MD 21811 | 2010-06-29 |
| 1255656062 | Sarah Mae Brown | Pharmacist | Apple Discount Drugs 314 Franklin Avenue, Berlin, MD 21811 | 2010-04-05 |
| Find all providers in zip 21811 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891291167 | Northeast Wisconsin Foot and Ankle Assoc., S.c. | Podiatrist | 225 Memorial Dr, Berlin, WI 54923-1243 | 2018-04-04 |
| 1104930163 | Foot Health Centers, P.a. | Podiatrist | 175 Cross Keys Rd, Suite 204, Berlin, NJ 08009-9263 | 2006-08-18 |
| 1609989755 | William G. Olischar | Podiatrist | 10031 Old Ocean City Blvd, Berlin, MD 21811-1171 | 2006-08-15 |
| 1609889377 | Kevin A. Mcnamara | Podiatrist | 130 Fisher Rd, Berlin, VT 05602-9516 | 2006-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295342236 | Podiatry Associates, P.a. | Podiatrist | 9403 Harford Rd Ste 5, Baltimore, MD 21234-3123 | 2020-09-24 |
| 1063029114 | Podiatry Associates, P.a. | Podiatrist | 404 Eastern Blvd Ste 1, Baltimore, MD 21221-6748 | 2020-09-23 |
| 1285259192 | Podiatry Associates, P.a. | Podiatrist | 110 Old Padonia Rd Ste 300, Cockeysville, MD 21030-4948 | 2020-06-16 |
| 1588295059 | Podiatry Associates, P.a. | Podiatrist | 1205 York Rd Ste 17, Lutherville, MD 21093-6211 | 2020-02-03 |
| 1861023327 | Podiatry Associates, P.a. | Podiatrist | 10 Warren Rd Ste 130, Cockeysville, MD 21030-2518 | 2020-02-03 |
| 1225669781 | Podiatry Associates, P.a. | Podiatrist | 2 E Rolling Xrds Ste 55, Catonsville, MD 21228-6212 | 2020-02-03 |
| 1114558681 | Podiatry Associates, P.a. | Podiatrist | 7131 Liberty Rd Ste 100, Baltimore, MD 21207-4580 | 2020-02-03 |
| 1952932428 | Podiatry Associates, P.a. | Podiatrist | 795 Aquahart Rd Ste 125, Glen Burnie, MD 21061-3905 | 2020-02-03 |
| 1861023335 | Podiatry Associates, P.a. | Podiatrist | 1500 Blenhiem Farm Ln Ste C, Havre De Grace, MD 21078-2042 | 2020-02-03 |
| 1336798719 | Podiatry Care Plus LLC | Podiatrist | 14201 Laurel Park Dr Ste 214, Laurel, MD 20707-5203 | 2019-09-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.