JENNIFER S GANNON (NPI# 1396703575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396703575 |
| Entity Type | Individual |
| Full Name | JENNIFER S GANNON |
| Credential | PA |
| Practice Address |
501 W 7th St Frederick MD 21701-4586 |
| Mailing Address |
Po Box 37086 Baltimore MD 21297-3086 |
| Practice Telephone | 3016639573 |
| Mailing Telephone | 2404398812 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2020-01-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
C0002836 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
C0002836 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 52 Thomas Johnson Dr, Frederick, MD 217024300 | 3016639573 | 3016636446 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699899567 | Jennifer Gannon | Pharmacist | 4151 S Canton Center Rd, Canton, MI 48188-2489 | 2007-03-18 |
| 1447308770 | Jennifer Nicole Gannon | Specialist/Technologist | 30 Railroad Ave, Centracare Clinic Albany, Albany, MN 56307-9363 | 2007-01-05 |
| 1194721241 | Jennifer Sakura Gannon | Optometrist | Blackfeet Community Hospital Eye Clinic, Hopsital Circle, Browning, MT 59417 | 2005-06-23 |
| 1598324949 | Jennifer Gannon | Registered Nurse | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2019-06-10 |
| 1619535648 | Jennifer Gannon | Case Manager/Care Coordinator | 445 E Dublin Granville Rd Ste G, Worthington, OH 43085-3183 | 2019-06-04 |
| 1780121327 | Jennifer Gannon | Student in an Organized Health Care Education/Training Program | 8000 York Rd, Towson University, Towson, MD 21252-0001 | 2017-01-20 |
| 1619396991 | Jennifer Gannon | Case Manager/Care Coordinator | 1804 S Eddy St, Grand Island, NE 68801-7114 | 2014-04-15 |
| 1740218270 | Jennifer L Gannon | Medical Genetics | 5808 W 110th St, Overland Park, KS 66211-2504 | 2006-06-30 |
| 1346287042 | Jennifer Botte Gannon | Obstetrics & Gynecology | Mount Kisco Medical Group PC, 90 South Bedford Rd, Mount Kisco, NY 10549-3412 | 2006-06-01 |
| Street Address |
501 W 7TH ST |
| City | FREDERICK |
| State | MD |
| Zip Code | 21701-4586 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477550986 | Kwok C. Lee | Radiology | 501 W 7th St, Ste 2, Frederick, MD 21701-4507 | 2005-06-30 |
| 1730707902 | Kelly Ann Schultheis | Nurse Practitioner | 501 W 7th St, Frederick, MD 21701-4586 | 2020-07-13 |
| 1598317893 | Frederick Health Medical Group LLC | Social Worker | 501 W 7th St, Frederick, MD 21701-4586 | 2019-07-16 |
| 1992265656 | Melanie Faith Ondrejko | Nurse Practitioner | 501 W 7th St, Frederick, MD 21701 | 2019-03-20 |
| 1477023174 | Meghan Matthews | Social Worker | 501 W 7th St, Frederick, MD 21701-4586 | 2018-11-26 |
| 1619446622 | Lemuel Carlo Lucas De Leon | Nurse Practitioner | 501 W 7th St, Frederick, MD 21701 | 2018-11-19 |
| 1447731724 | Brian Kristian Strahl | Physician Assistant | 501 W 7th St, Frederick, MD 21701-4586 | 2018-08-24 |
| 1215423181 | Frederick Health Hospital Inc | Clinical Medical Laboratory | 501 W 7th St, Frederick, MD 21701-4586 | 2018-07-03 |
| 1033605902 | Frederick Health Hospital Inc | Radiology | 501 W 7th St, Frederick, MD 21701-4586 | 2018-07-03 |
| 1841782836 | Frederick Health Medical Group LLC | Clinic/Center | 501 W 7th St, Frederick, MD 21701-4586 | 2018-06-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225670045 | Alana Earp | Social Worker | 810 Toll House Avenue, Frederick, MD 21701 | 2019-10-14 |
| 1851866065 | Main Place Treatment Centers LLC. | Clinic/Center | 127 S. Smallwood Street, Frederick, MD 21701 | 2018-10-04 |
| 1649775933 | Old Fashion Medicine, Inc | Internal Medicine | 95 Gatepost Lane, Apartment 1b, Frederick, MD 21701 | 2018-03-28 |
| 1063917938 | Kristin Deely | Nurse Practitioner | 400 West 7th Street, Cardiac Cath Lab 2nd Floor, Frederick, MD 21701 | 2018-03-24 |
| 1689180119 | Harwood Behavioral Health Partners, LLC | Community/Behavioral Health | 300 B Scholls Lane, Frederick, MD 21701 | 2017-12-20 |
| 1326590068 | Natalie Reid | Nurse Practitioner | 9093 Ridgefield Dr Ste 104, Frederick, MD 21701 | 2016-10-28 |
| 1649727967 | Scl Corpration | In Home Supportive Care | 550 Highland Street, Suite 110, Frederick, MD 21701 | 2016-09-02 |
| 1891159661 | Wellave, LLC | Clinic/Center | 411 Aviation Way Ste 245, Frederick, MD 21701 | 2016-04-07 |
| 1144694969 | Leslee Bry | Counselor | 120 W Church St Ste 3b, Frederick, MD 21701 | 2015-11-17 |
| 1851797732 | Frederick Dental | Dentist | 401 W 7th Street, Frederick Dental, Frederick, MD 21701 | 2014-11-05 |
| Find all providers in zip 21701 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972599678 | Michael D Kennedy | Physician Assistant | 86 Thomas Johnson Ct, Frederick, MD 21702-4348 | 2005-09-27 |
| 1295250728 | Laura York | Physician Assistant | 81 Thomas Johnson Ct Ste A, Frederick, MD 21702-4674 | 2017-08-05 |
| 1063892503 | Mitchel Eh Sicard | Physician Assistant | 5257 Buckeystown Pike, #244, Frederick, MD 21704-7535 | 2015-05-30 |
| 1275792095 | Rommie Navylia Abele | Physician Assistant | 86 Thomas Johnson Ct, Frederick, MD 21702-4348 | 2008-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205475803 | Kendy Karenys Lopez | Physician Assistant | 18324 Streamside Dr Apt 204, Gaithersburg, MD 20879-5228 | 2019-12-30 |
| 1528619640 | Cindy Pham | Physician Assistant | 7515 Oyster Bay Way, Gaithersburg, MD 20886-5905 | 2019-09-20 |
| 1508336637 | Victor Orlando Hernandez | Physician Assistant | 125 Potomac Psge Unit 200, Oxon Hill, MD 20745-1580 | 2018-12-02 |
| 1164905824 | Surgical Focus LLC | Physician Assistant | 5550 Friendship Blvd Ste 100, Chevy Chase, MD 20815-7294 | 2018-09-10 |
| 1912497173 | Gem Y Walker Lawson | Physician Assistant | 6500 Rock Spring Dr Ste 100, Bethesda, MD 20817-1182 | 2018-05-14 |
| 1306341540 | Sunil Harris | Physician Assistant | 22 S. Green St, University of Maryland Medical Center, Baltimore, MD 21201-1595 | 2018-03-29 |
| 1134639263 | Liz Ramirez | Physician Assistant | 1101 E 33rd St, Baltimore, MD 21218-3637 | 2017-10-03 |
| 1093231755 | Daniel Gentry | Physician Assistant | 301 Saint Paul St Ste Pob 802, Baltimore, MD 21202-2102 | 2017-08-15 |
| 1467981431 | Lana E Grubb | Physician Assistant | 12502 Willowbrook Rd Ste 470, Cumberland, MD 21502-6593 | 2017-06-05 |
| 1174051353 | Nam Anh Pham | Physician Assistant | 227 Saint Paul St Fl 6, Baltimore, MD 21202-2001 | 2017-05-31 |
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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.