JOHN R GANNON (NPI# 1861634289) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861634289 |
| Entity Type | Individual |
| Full Name | JOHN R GANNON |
| Credential | M.D. |
| Practice Address |
935 Highland Blvd Ste 2160 Bozeman MT 59715-6913 |
| Mailing Address |
915 Highland Blvd Bozeman MT 59715-6902 |
| Practice Telephone | 4064145300 |
| Mailing Telephone | 4064141671 |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 58876 | MT | Allopathic & Osteopathic Physicians |
| N | 208800000X | Urology | 208800000X | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1861634289 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4245 Roosevelt Way Ne, Suite 300, Seattle, WA 981056008 | 2065986358 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730706839 | John James Gannon | Family Medicine | Prisma Health Medical Group Family Medicine, 3209 Colonial Drive, Columbia, SC 29203 | 2020-07-06 |
| 1205253614 | John William Gannon | Dentist | 8315 Walnut Hill Ln Ste 120, Dallas, TX 75231 | 2014-03-24 |
| 1386841088 | John Kevin Gannon | Speech-Language Pathologist | 91 High St, Monroe, NY 10950-3305 | 2007-06-27 |
| 1073691119 | John Gannon | Psychologist | 2640 Aquetong Rd, New Hope, PA 18938-5602 | 2006-11-02 |
| 1457666919 | John Gannon | Licensed Practical Nurse | 1900 Genesee St, Utica, NY 13502-5635 | 2010-08-09 |
| Street Address |
935 HIGHLAND BLVD STE 2160 |
| City | BOZEMAN |
| State | MT |
| Zip Code | 59715-6913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457443251 | Bjorn Sauerwein | Urology | 935 Highland Blvd Ste 2160, Bozeman, MT 59715-6913 | 2006-09-29 |
| 1851624340 | Derrick A Rowe | Physician Assistant | 935 Highland Blvd Ste 2160, Bozeman, MT 59715-6913 | 2009-09-15 |
| 1730228735 | Gregory Pritham | Urology | 935 Highland Blvd Ste 2160, Bozeman, MT 59715-6913 | 2007-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477152288 | Ch Mh Services (il), LLC | Clinic/Center | 233 E Main St Suite 401, Bozeman, MT 59715 | 2020-10-22 |
| 1134735269 | Montana Therapy and Consulting Pllc | Social Worker | 110 S Grand Ave, Floor 2, Bozeman, MT 59715 | 2020-09-23 |
| 1831715994 | Alyson Raph | Student in an Organized Health Care Education/Training Program | 1 Anna Pearl Sherrick Hal, Bozeman, MT 59715 | 2020-06-24 |
| 1639702780 | Miranda Shields | Massage Therapist | 1001 W. Oak St. Bldg C Ste 210, Bozeman, MT 59715 | 2020-02-18 |
| 1154988590 | Christina Yancy | Massage Therapist | Bldg C, Ste 210, 1001 W Oak St, Bozeman, MT 59715 | 2019-05-21 |
| 1962068767 | Julie A Hisey | Physical Therapist | 1700 W. Koch, Suite 12, Bozeman, MT 59715 | 2019-05-16 |
| 1639631633 | Joshua Wallace | Massage Therapist | 1001 W Oak St, Bldg. C Ste. 210, Bozeman, MT 59715 | 2019-04-01 |
| 1528523388 | Judith Margaret Firehammer | Psychologist | 37 East Main St, Suite 7, Bozeman, MT 59715 | 2019-02-06 |
| 1194280875 | Erica Kotick | Counselor | 2246 Boot Hill Court, Suite 4, Bozeman, MT 59715 | 2019-02-06 |
| 1194291609 | Providence Mental Health Pllc | Social Worker | 2246 Boot Hill Ct. Unit #4, Bozeman, MT 59715 | 2018-10-23 |
| Find all providers in zip 59715 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275657371 | James Bruce Robertson | Urology | 2002 N 22nd Ave Ste 1, Bozeman, MT 59718-3153 | 2007-03-16 |
| 1457443251 | Bjorn Sauerwein | Urology | 935 Highland Blvd Ste 2160, Bozeman, MT 59715-6913 | 2006-09-29 |
| 1487205670 | Montana Medical Solutions Pllc | Urology | 2002 N 22nd Ave Ste 1, Bozeman, MT 59718-3153 | 2019-09-27 |
| 1134449267 | Jason Farrell Skenazy | Urology | 935 Highland Blvd, Bozeman, MT 59715-6904 | 2010-06-11 |
| 1730228735 | Gregory Pritham | Urology | 935 Highland Blvd Ste 2160, Bozeman, MT 59715-6913 | 2007-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134548597 | Jeffrey Devin Redshaw | Urology | 2875 Tina Ave Ste 101, Missoula, MT 59808-1582 | 2014-04-15 |
| 1922345396 | Dayton Rusby Seabaugh | Urology | 395 Lower Valley Rd, Kalispell, MT 59901-7974 | 2013-01-05 |
| 1285928754 | Richard Craig Slater | Urology | 3000 15th Ave S Dept Of, Great Falls, MT 59405-5240 | 2011-06-02 |
| 1588955256 | Michael J Berson | Urology | 169 Sunset Trl, Kalispell, MT 59901-7820 | 2011-04-28 |
| 1154557999 | Michael Oliver Hickman Jr. | Urology | 2900 12th Ave N Ste 503e, Billings, MT 59101-7502 | 2009-06-08 |
| 1306091541 | Michael B Agee | Urology | 429 S Cooke St, Helena, MT 59601-5147 | 2008-12-01 |
| 1891886867 | Urology Associates PC | Urology | 350 Heritage Way Ste 2300, Kalispell, MT 59901-3167 | 2006-09-27 |
| 1598867061 | Craig Grinnell Hinman | Urology | 625 7th Ave E, Kalispell, MT 59901-5050 | 2006-09-03 |
| 1093822736 | Joseph Peter Nicoletto | Urology | 308 Louisiana Ave Ste 1, Libby, MT 59923-2159 | 2006-08-25 |
| 1366450488 | Leonard Charles Christensen | Urology | Vhafhm, 1892 Williams St, Fort Harrison, MT 59636 | 2006-08-04 |
| 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.