DR. JOHN DAVID BANNON (NPI# 1396718201) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396718201 |
| Entity Type | Individual |
| Full Name | DR. JOHN DAVID BANNON |
| Other Name | DR. J. DAVID BANNON |
| Credential | MD,FACS |
| Practice Address |
543 Bay Rd Queensbury NY 12804-1441 |
| Practice Telephone | 5187612663 |
| Practice Fax Number | 5187616831 |
| Mailing Telephone | 5187612663 |
| Mailing Fax Number | 5187616831 |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 136663 | NY | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00832751 | 05 | |
| NY | DEA | BB1015088 | 01 |
| NY | LICENSE | 136663 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467420042 | John T Bannon | Orthopaedic Surgery | 141 Shore Rd, Somers Point, NJ 08244-2739 | 2006-03-09 |
| Street Address |
543 BAY RD |
| City | QUEENSBURY |
| State | NY |
| Zip Code | 12804-1441 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831481274 | Jennifer Wright | Physician Assistant | 543 Bay Rd, Queensbury, NY 12804-1441 | 2011-05-04 |
| 1124286620 | Alfred E Kristensen Md Pllc | Specialist | 543 Bay Rd, Queensbury, NY 12804-1441 | 2008-05-30 |
| 1780618983 | J. David Bannon Md PC | Specialist | 543 Bay Rd, Queensbury, NY 12804-1441 | 2006-07-11 |
| 1386600591 | David J Paska | Physician Assistant | 543 Bay Rd, Queensbury, NY 12804-1441 | 2006-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265060958 | Dani Grace Filicetti | Student in an Organized Health Care Education/Training Program | 423 Bay Rd, Queensbury, NY 12804 | 2020-03-30 |
| 1861977704 | Leslie Ann Warren | Counselor | 24 Cedarwood Drive, Queensbury, NY 12804 | 2018-09-26 |
| 1598294910 | Molly Gillespie | Speech-Language Pathologist | 9 Sylvan Ave, Queensbury, NY 12804 | 2017-06-08 |
| 1306207196 | Dorothy Duggan | Registered Nurse | 128 Aviation Road, Queensbury, NY 12804 | 2016-03-08 |
| 1568731115 | Kph Healthcare Services, Inc. | Pharmacy | 161 Carey Road, Queensbury, NY 12804 | 2011-12-27 |
| 1164701017 | Wal-mart Stores East Lp | Technician/Technologist | 24 Quaker Ridge Blvd, Queensbury, NY 12804 | 2011-08-10 |
| 1821275256 | Koock E Jung Md PC | Social Worker | 597 Bay Road, Queensbury, NY 12804 | 2008-01-29 |
| 1477765246 | Warren Washington Counties Chapter Nysarc Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 375 Bay Road, Suite 200, Queensbury, NY 12804 | 2007-05-04 |
| 1336299742 | Town of Queensbury Union Free School District 2 | Local Education Agency (LEA) | 429 Aviation Road, Queensbury, NY 12804 | 2007-01-11 |
| 1578658761 | Richard Jay Reisman | Dentist | 8 Baywood Drive, Glens Falls, NY 12804 | 2006-10-04 |
| Find all providers in zip 12804 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306397302 | Shelly Alexander | Specialist | 22 Colonial Ct, Queensbury, NY 12804-1948 | 2016-10-14 |
| 1003264268 | Mary H Tyree | Specialist | 53 Kettles Way, Queensbury, NY 12804-6412 | 2016-05-28 |
| 1053757229 | Stephen Bush | Specialist | 68 Queensbury Ave, Queensbury, NY 12804-7600 | 2013-05-15 |
| 1144584111 | Stephanie Eva Atamanchuk | Specialist | 30 Sweet Rd, Queensbury, NY 12804-1723 | 2012-06-25 |
| 1447361712 | Hughes Ent Associates Md PC | Specialist | 383 Bay Rd, Queensbury, NY 12804-1405 | 2006-08-31 |
| 1124625553 | Chris Ann Bocko-wettersten | Specialist | 413 Bay Rd, Queensbury, NY 12804-1408 | 2020-10-08 |
| 1205176039 | Shelly Ann Moore | Specialist | 34 Margaret Dr, Queensbury, NY 12804-9164 | 2013-02-14 |
| 1194080598 | Aimee Elizabeth Martin | Specialist | 133 Aviation Rd, Queensbury, NY 12804-8206 | 2012-07-11 |
| 1124286620 | Alfred E Kristensen Md Pllc | Specialist | 543 Bay Rd, Queensbury, NY 12804-1441 | 2008-05-30 |
| 1447329552 | Richard Hughes Md Ent PC | Specialist | 383 Bay Rd, Queensbury, NY 12804-1405 | 2006-11-06 |
| Find all providers in QUEENSBURY | ||||
| City | QUEENSBURY |
| Zip Code | 12804 |
Please comment or provide details below to improve the information on DR. JOHN DAVID BANNON.
| 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.