DR. MICHAEL GANNON (NPI# 1225441215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225441215 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL GANNON |
| Credential | MD |
| Practice Address |
2531 Landmark Dr Ste 103 Clearwater FL 33761-3928 |
| Mailing Address |
2995 Drew St Fl 2 Clearwater FL 33759-3012 |
| Practice Telephone | 7277964396 |
| Practice Fax Number | 8136357867 |
| Mailing Telephone | 7275321355 |
| Mailing Fax Number | 8136352613 |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2019-10-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | ME141249 | FL | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | 25MA09511000 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 104323800 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033623111 | Michael James Gannon | Pharmacist | 833 S Wood St Fl 3, Chicago, IL 60612-7229 | 2017-11-27 |
| 1962809699 | Michael Walsh Gannon | Counselor | 109 Cloud Touch Ct, Roseville, CA 95747-7116 | 2014-11-24 |
| 1194086041 | Michael Patrick Gannon | Internal Medicine | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2012-06-06 |
| 1366582710 | Michael J Gannon | Internal Medicine | 2741 Wheaton Way, Bremerton, WA 98310-3344 | 2007-02-07 |
| 1316096480 | Michael Lawrence Gannon | Dentist | 138 Church St Ne, Vienna, VA 22180-4543 | 2007-01-09 |
| 1790704856 | Michael Kevin Gannon | Orthopaedic Surgery | 2979 Squalicum Pkwy, Suite #203, Bellingham, WA 98225-1811 | 2006-07-19 |
| 1528060654 | Michael James Gannon | Family Medicine | 11452 Space Center Blvd, Houston, TX 77059 | 2005-08-10 |
| Street Address |
2531 LANDMARK DR STE 103 |
| City | CLEARWATER |
| State | FL |
| Zip Code | 33761-3928 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255851937 | Constance Brooks Scripture | Nurse Practitioner | 2531 Landmark Dr Ste 103, Clearwater, FL 33761-3928 | 2017-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770184210 | Sandra Shanice Campisi | Behavior Technician | 29228 Us-19 N, Clearwater, FL 33761 | 2020-11-02 |
| 1659838449 | Branden Kleehammer | Occupational Therapy Assistant | 6941 300th Ave N, Clearwater, FL 33761 | 2019-02-27 |
| 1063901403 | Sheleaha C Egly I | Behavior Technician | 29288 Us Highway 19 N, Clearwater, FL 33761 | 2018-05-01 |
| 1760979629 | Melissa Irene Valentine | Social Worker | 6997 300th Ave North, Clearwater, FL 33761 | 2018-04-17 |
| 1871011049 | Maria's Adult Day Care Center | Clinic/Center | 26224 Us Highway 19 N., Clearwater, FL 33761 | 2017-09-07 |
| 1962933739 | Robert Hudson | Occupational Therapist | 3463 Northridge Dr, Clearwater, FL 33761 | 2017-03-23 |
| 1366985582 | Brandon Chad Brown | Physician Assistant | 29277 Hwy 19 North, Clearwater, FL 33761 | 2016-11-19 |
| 1730575606 | Layne S Winker | Physician Assistant | 26812 Us 19 N # 19, Clearwater, FL 33761 | 2015-04-08 |
| 1407254907 | M Christina Memoli Od Pa | Optometrist | 27901 Us 19 N, Clearwater, FL 33761 | 2014-12-15 |
| 1952729774 | Gina Pietras Spohn | Dermatology | 3165 N Mcmullen Booth Rd Bldg B, Clearwater, FL 33761 | 2014-03-29 |
| Find all providers in zip 33761 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902354517 | Lance Lieberman | Family Medicine | 25941 Us 19 N, Suite/po 15212, Clearwater, FL 33763-2013 | 2016-09-13 |
| 1295186351 | Kah Development 7, L.L.C. | Family Medicine | 380 Park Place Blvd Ste 230, Clearwater, FL 33759-4930 | 2016-06-29 |
| 1104289115 | Brian Patrick Mcdaniel | Family Medicine | 400 Pinellas St Ste 350, Clearwater, FL 33756-3319 | 2016-03-29 |
| 1467873315 | Community Health Center of Pinellas Inc | Family Medicine | 5523 Roosevelt Blvd, Clearwater, FL 33760-3425 | 2013-12-19 |
| 1588005185 | Nadia Nirmalene Gomes | Family Medicine | 1007 Jeffords St Ste 101, Clearwater, FL 33756-4082 | 2013-07-11 |
| 1649513276 | Kerry Eileen Reller | Family Medicine | 708 Druid Rd. E, Clearwater, FL 33756 | 2013-04-02 |
| 1427323351 | Nancy L Robbin, M.d. Pa | Family Medicine | 2555 Enterprise Rd Ste 9-3, Clearwater, FL 33763-1150 | 2012-03-10 |
| 1679845374 | Inpatient Consultants of Florida, Inc | Family Medicine | 1700 N Mcmullen Booth Rd Ste D1, Clearwater, FL 33759-2129 | 2012-01-27 |
| 1760791859 | Bayside Family Healthcare Clearwater, LLC | Family Medicine | 107 N Mcmullen Booth Rd, Clearwater, FL 33759-4450 | 2010-10-06 |
| 1558598193 | Melissa Allyn Morgan | Family Medicine | 2855 Gulf To Bay Blvd Apt 9303, Clearwater, FL 33759-4057 | 2009-06-22 |
| Find all providers in CLEARWATER | ||||
| City | CLEARWATER |
| Zip Code | 33761 |
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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.