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TIMOTHY WADE CANNON D.C.
NPI 1952722290
Chiropractor in Ammon, ID

Active since January 03, 2014Accepts Medicare Assignment
611 ENSIGN DR, AMMON, ID 83406(208) 557-1880 Get Directions Write a Review

NPPES record last updated: February 9, 2017. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 9, 2017, Feb 1, 2017, Nov 1, 2016 and 1 more (4 updates tracked since 2016).

About Timothy Wade Cannon D.c. NPPES

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

TIMOTHY WADE CANNON D.C. (NPI 1952722290) is an individual chiropractor in Ammon, Idaho, licensed in Idaho (CHIA-1580) and active in the NPI registry since January 2014. He is a graduate of Western States College Of Chiropractic (2013).

NPPES Registry Identity

NPI1952722290
Entity TypeIndividualMale
Primary Taxonomy111N00000X
Provider Legal NameTIMOTHY WADE CANNONCredential: D.C.
Location Address611 ENSIGN DRAmmon, ID 83406-4777
Mailing Address611 Ensign DrAmmon, ID 83406-4777 · (208) 557-1880
Phone(208) 557-1880
Sole ProprietorYes
Medical School CMSWestern States College Of ChiropracticGraduated 2013
Enumeration DateJanuary 3, 2014
Last NPPES UpdateFebruary 9, 20174 updates tracked since enumeration
✔ NPI 1952722290 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in ID · CHIA-1580
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
611 ENSIGN DR, Ammon, ID 83406
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Timothy Wade Cannon D.c. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4385874270
PECOS Enrollment IDI20251125004738

Medicare Billing Reassignments

2

Medicare enrollment records show Timothy Cannon reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Aspen Injury Center LLC
557 mi
Chiropractor
1260 E MAIN ST
Cottage Grove, OR 97424
  • Reassigned Medicare billing, Oregon enrollment
  • 5 clinicians in this Medicare group
NPI 1902370810 (541) 767-3788
Umpqua Chiropractic PC
574 mi
Chiropractor
535 NE STEPHENS ST
Roseburg, OR 97470
  • Reassigned Medicare billing, Oregon enrollment
  • 4 clinicians in this Medicare group
NPI 1124644216 (541) 672-4807

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

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Timothy Cannon's NPI number?

The NPI number for Timothy Cannon is 1952722290. It was assigned to this individual provider in the NPPES registry on January 3, 2014.

Where is Timothy Cannon located?

Timothy Cannon practices at 611 Ensign Dr, Ammon, ID 83406. The listed phone number is (208) 557-1880.

What is Timothy Cannon's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Timothy Cannon enrolled in Medicare?

Yes. Timothy Cannon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Timothy Cannon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Timothy Cannon reassigns Medicare benefits to 2 organizations: Aspen Injury Center LLC (Cottage Grove, OR) and Umpqua Chiropractic PC (Roseburg, OR). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Timothy Cannon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Timothy Cannon accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and Regence BlueCross BlueShield of Oregon list Timothy Cannon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Timothy Cannon was last updated on February 9, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.