DR. PETER M CANNON (NPI# 1326032939) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326032939 |
| Entity Type | Individual |
| Full Name | DR. PETER M CANNON |
| Credential | M.D. |
| Practice Address |
2001 S Woodruff Ave Suite 4 Idaho Falls ID 83404-6374 |
| Practice Telephone | 2085244511 |
| Practice Fax Number | 2085244540 |
| Mailing Telephone | 2085244511 |
| Mailing Fax Number | 2085244540 |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2011-04-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | M-3494 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 002502000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114225315 | Peter John Cannon | Anesthesiology | 24931 Larson Rd, Monroe, OR 97456-8713 | 2011-03-11 |
| 1467623959 | Peter Noel Cannon | Dentist | 400 Robert St N Ste 270, Saint Paul, MN 55101-2015 | 2008-03-12 |
| Street Address |
2001 S WOODRUFF AVE SUITE 4 |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83404-6374 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902809221 | James L. Richards | Surgery | 2001 S Woodruff Ave, Ste 3, Idaho Falls, ID 83404-6371 | 2005-05-31 |
| 1568912962 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 2001 S Woodruff Ave, Suite 7, Idaho Falls, ID 83404-6374 | 2016-10-10 |
| 1780043042 | Teton Obstetrics and Gynecology Pa | Obstetrics & Gynecology | 2001 S Woodruff Ave, Suite 10, Idaho Falls, ID 83404-6374 | 2016-02-15 |
| 1730563909 | Radial First Cardiovascular Associates, LLC | Internal Medicine | 2001 S Woodruff Ave, Suite 3, Idaho Falls, ID 83404-6371 | 2015-07-16 |
| 1609263482 | Chad Steven Dahle | Spec/Tech, Cardiovascular | 2001 S Woodruff Ave, Suite 12 B, Idaho Falls, ID 83404-6374 | 2015-04-20 |
| 1225314677 | Janae Lynn Dye | Respiratory Therapist, Certified | 2001 S Woodruff Ave, Idaho Falls, ID 83404-6374 | 2011-10-31 |
| 1366747594 | Will G Stewart | Respiratory Therapist, Registered | 2001 S Woodruff Ave, Suite 12b, Idaho Falls, ID 83404-6374 | 2011-01-19 |
| 1043546260 | Ihc Health Services Inc | Internal Medicine | 2001 S Woodruff Ave, #12, Idaho Falls, ID 83404-6374 | 2009-10-22 |
| 1609008614 | Blake A. Stragier | Technician, Cardiology | 2001 S Woodruff Ave, Suite 12 B, Idaho Falls, ID 83404-6374 | 2009-08-10 |
| 1770712762 | Brandy Skaar | Respiratory Therapist, Registered | 2001 S Woodruff Ave, Suite 12 B, Idaho Falls, ID 83404-6374 | 2009-07-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750809 | Joshua M Murphy | Dentist | 1580 Elk Creek Dr., Idaho Falls, ID 83404 | 2020-11-03 |
| 1427618958 | Eastern Idaho Endodontics | Dentist | 3335 S. Holmes Ave, Idaho Falls, ID 83404 | 2019-06-17 |
| 1942863600 | Muhammad Arslan Khan | Student in an Organized Health Care Education/Training Program | 2860 Channing Way Suite 214, Idaho Falls, ID 83404 | 2019-04-18 |
| 1942771043 | Physician's Choice Cardiology, Pllc | Internal Medicine | 3302 Valencia, Suite 201, Idaho Falls, ID 83404 | 2018-12-16 |
| 1609358761 | Cardiac Cath Lab of Idaho Falls | Internal Medicine | 3311 Valencia Drive, Idaho Falls, ID 83404 | 2018-09-05 |
| 1083196380 | Hannah Golden | Occupational Therapist | 1460 Elk Creek, Idaho Falls, ID 83404 | 2018-09-04 |
| 1316423049 | Lindsay Sessions | Speech-Language Pathologist | 2210 Niagara St, Idaho Falls, ID 83404 | 2018-07-16 |
| 1720574023 | Bmh, Inc. | Anesthesiology | 3302 Valencia Dr., Suite 201, Idaho Falls, ID 83404 | 2018-07-10 |
| 1093237935 | Jason Earl Bailey | Contractor | 3100 S Woodruff Ave., Idaho Falls, ID 83404 | 2017-07-12 |
| 1235682121 | Mountain Falls Quick Care | Clinic/Center | 1995 E 17th St #1, Idaho Falls, ID 83404 | 2016-07-27 |
| Find all providers in zip 83404 | ||||
| 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 |
|---|---|---|---|---|
| 1154682565 | Richard Alan Blatter | Urology | 2001 S Woodruff Ave Ste 4, Idaho Falls, ID 83404-6371 | 2012-06-01 |
| 1033121322 | Timothy Osborn Taylor | Urology | 2330 Coronado St, Idaho Falls, ID 83404-7407 | 2006-08-13 |
| 1679528632 | Duncan Dwaynne Harris | Urology | 3200 Channing Way Ste A205, Idaho Falls, ID 83404-7586 | 2006-05-24 |
| 1972604494 | Roger H Tall | Urology | 2001 S Woodruff, Suite 8, Idaho Falls, ID 83404 | 2006-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699242123 | Treasure Valley Urology Pllc | Urology | 3090 E Gentry Way Ste 220, Meridian, ID 83642-3550 | 2018-11-02 |
| 1750648002 | Jason Orien | Urology | 777 Hospital Way Ste 215, Pocatello, ID 83201-5175 | 2012-04-11 |
| 1972892669 | David Flores | Urology | 980 W Ironwood Dr Ste 104, Coeur D Alene, ID 83814-2668 | 2011-04-04 |
| 1346407921 | Helen Jia-ru Kuo | Urology | 2855 E. Magic View Drive, Meridian, ID 83642 | 2008-05-21 |
| 1144344391 | Robert W. Bohus, M.d., F.a.c.s. | Urology | 500 S 11th Ave Ste 301, Pocatello, ID 83201-4879 | 2007-03-16 |
| 1346375235 | Edward D Ellison | Urology | 980 Ironwood Dr W, Ste 104, Coeur D' Alene, ID 83814 | 2007-02-22 |
| 1316028889 | Edwin Manley Briggs | Urology | 1316 Harrison Blvd, Boise, ID 83702-3444 | 2006-10-18 |
| 1710097068 | Jared G Heiner | Urology | 3085 E Magic View Dr Ste 140, Meridian, ID 83642-3745 | 2006-08-30 |
| 1689617722 | A P Mclaughlin IIi Apc | Urology | 120 N Leadville, Ketchum, ID 83340 | 2006-06-14 |
| 1194763151 | Donald L Weese, M.d., P.C. | Urology | 844 Washington St N, Number 400, Twin Falls, ID 83301-3874 | 2006-06-03 |
| Find all providers with the same taxonomy | ||||
| City | IDAHO FALLS |
| Zip Code | 83404 |
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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.