DR. DAVID MICHAEL GANNON MD
NPI 1548901580
Student in an Organized Health Care Education/Training Program in Kalamazoo, MI

Q: What is David Gannon's NPI number?

The NPI number for David Gannon is 1548901580. It was assigned to this individual provider in the NPPES registry on April 5, 2022.

Q: What is David Gannon's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for David Gannon was last updated on August 2, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 05, 2022PECOS Enrolled

1000 OAKLAND DR, KALAMAZOO, MI 49008(269) 337-4400 Get Directions Write a Review

NPPES record last updated: August 2, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. David Michael Gannon Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DAVID MICHAEL GANNON MD (NPI 1548901580) is an individual student in an organized health care education/training program in Kalamazoo, Michigan, licensed in Michigan (4351051568) and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS and maintains a secondary practice location in Maywood.

NPPES Registry Identity

NPI1548901580

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDR. DAVID MICHAEL GANNONCredential: MD

Location Address1000 OAKLAND DRKalamazoo, MI 49008-1282

Mailing Address1000 Oakland DrKalamazoo, MI 49008-1284 · (269) 344-4600

Phone(269) 337-4400

Sole ProprietorNo

Enumeration DateApril 5, 2022

Last NPPES UpdateAugust 2, 2023

NPPES CertifiedAugust 2, 2023

✔ NPI 1548901580 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

License✔ Licensed in MI · 4351051568

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Also ListedSurgeryTaxonomy 208600000X · License 125.080165 (IL)

1000 OAKLAND DR, Kalamazoo, MI 49008

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Secondary Practice Location 1

Location 12160 S 1st AveMaywood, IL 60153-3328 · Phone (651) 895-9812

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. David Michael Gannon Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANDREW MATTINGLY MD

Student in an Organized Health Care Education/Training Program