DAVID GANNON DPM LLC (NPI# 1861415200) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861415200 |
| Entity Type | Organization |
| Organization Name | DAVID GANNON DPM LLC |
| Other Organization Name | SHORE FOOT & ANKLE |
| 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 | 2006-07-26 |
| Last Update Date | 2009-11-30 |
| Authorized Official Name | DR. DAVID GANNON (PODIATRIST/SOLE OWNER) |
| Authorized Official Telephone | 4106290222 |
| Authorized Official Credential | D.P.M. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
01311 | MD | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DME | 6031730001 | 01 | |
| MD | 4150953-00 | 05 | |
| MD | RAIL ROAD MEDICARE GROUP PTAN | DN7994 | 01 |
| Other Name | Type Code |
|---|---|
| Shore Foot & Ankle | Doing Business As Name - Organization |
| Street Address |
9956 N MAIN ST SUITE #5 |
| City | BERLIN |
| State | MD |
| Zip Code | 21811-1077 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376521492 | David Gannon | Podiatrist | 9956 N Main St, Suite #5, Berlin, MD 21811-1077 | 2006-01-09 |
| 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 |
| 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 | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558774117 | Alison Marie Migonis | Podiatrist | 130 Fisher Rd Ste 4, Berlin, VT 05602-9516 | 2014-06-11 |
| 1720333438 | Ciara Hollister | Podiatrist | 130 Fisher Rd, Mob-b Suite 4, Berlin, VT 05602-9516 | 2012-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336773639 | Rosedale Podiatry Associates | Podiatrist | 9106 Philadelphia Rd Ste 204, Baltimore, MD 21237-4333 | 2020-02-25 |
| 1003447574 | Podiatry Associates Ambulatory Surgery Centers | Podiatrist | 6569 N Charles St Ste 702, Towson, MD 21204-6832 | 2020-02-03 |
| 1770143497 | Cassandre Charles | Podiatrist | 10 N Greene St Ste 112b, Baltimore, MD 21201-1524 | 2019-06-14 |
| 1720566466 | Rene Siazon Juridico | Podiatrist | 10 N Greene St # 112b, Baltimore, MD 21201-1524 | 2018-08-03 |
| 1922520063 | Maryland Foot & Ankle Reconstruction Group LLC | Podiatrist | 14301 Autumn Gold Rd, Boyds, MD 20841-4208 | 2017-07-11 |
| 1376073171 | Laura Ashley Michetti | Podiatrist | 10264 Southern Maryland Blvd Ste 105, Dunkirk, MD 20754-3037 | 2017-06-14 |
| 1235671298 | David Lee Reicher | Podiatrist | 12138 Heneson Garth, Owings Mills, MD 21117-1600 | 2016-11-08 |
| 1942756275 | Adam Weaver | Podiatrist | 139 Old Solomons Island Rd Ste C, Annapolis, MD 21401-0902 | 2016-08-28 |
| 1528419595 | Kristen Rose Cadieux | Podiatrist | 16 North Laplata Court, Laplata, MD 20646-4200 | 2016-06-30 |
| 1073962270 | Farzad Saleh | Podiatrist | 6130 Oxon Hill Rd Ste 305, Oxon Hill, MD 20745-3168 | 2016-06-08 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DAVID GANNON DPM LLC.
| 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.