GARY CANNON D.O.
NPI 1659357051
Family Medicine in Collinsville, OK

Q: What is Gary Cannon's NPI number?

The NPI number for Gary Cannon is 1659357051. It was assigned to this individual provider in the NPPES registry on December 16, 2005.

Q: What is Gary Cannon's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Gary Cannon was last updated on January 26, 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 December 16, 2005PECOS Enrolled

79.39/100

CMS Quality Rating

11610 N 137TH E AVE, COLLINSVILLE, OK 74021(918) 272-2247(918) 272-6185 Get Directions Write a Review

NPPES record last updated: January 26, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 26, 2023, Jan 3, 2023 (2 updates tracked since 2023).

On this page

About Gary Cannon D.o. NPPES

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

GARY CANNON D.O. (NPI 1659357051) is an individual family medicine provider in Collinsville, Oklahoma, licensed in Oklahoma (1937) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1659357051

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameGARY CANNONCredential: D.O.

Location Address11610 N 137TH E AVECollinsville, OK 74021

Mailing Address6600 S Yale Ave Ste 1400Tulsa, OK 74136-3331 · (888) 247-0125 · Fax (918) 502-8210

Phone(918) 272-2247

Fax(918) 272-6185

Sole ProprietorNo

Enumeration DateDecember 16, 2005

Last NPPES UpdateJanuary 26, 20232 updates tracked since enumeration

NPPES CertifiedJanuary 20, 2023

✔ NPI 1659357051 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in OK · 1937

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

11610 N 137TH E AVE, Collinsville, OK 74021

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gary Cannon D.o. 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.

Medicare Billing Reassignment

Medicare enrollment records show Gary Cannon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Warren Clinic Inc

21 mi

General Practice

6600 S YALE AVE, SUITE 1400
Tulsa, OK 74136

Reassigned Medicare billing, Oklahoma enrollment
1,144 clinicians in this Medicare group

NPI 1174582282 (918) 488-6001

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 74021 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.46 typical visit price

range $53.00 – $162.61

Typical copayment $20.61 (range $13.25 – $40.65)

Most-billed visit code 99203

Established Patient

$94.27 typical visit price

range $16.68 – $132.40

Typical copayment $23.56 (range $4.17 – $33.10)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

79.39/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

77.76

Promoting Interoperability

Improvement Activities

Cost

54.37

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

7 suppliers16 claims33 services$6.23 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier19 claims19 services$13.08 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

1 supplier19 claims19 services$63.92 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 5

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

JOSEPH KOENIG M.D.

Family Medicine