GWEN R CANNON (NPI# 1770694309) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770694309 |
| Entity Type | Individual |
| Full Name | GWEN R CANNON |
| Practice Address |
280 N Main St Bountiful UT 84010-6136 |
| Mailing Address |
Po Box 27128 Salt Lake City UT 84127-0128 |
| Practice Telephone | 8012949933 |
| Mailing Telephone | 8012334400 |
| Mailing Fax Number | 8012334410 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2012-09-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 831701581205 | UT | Allopathic & Osteopathic Physicians |
| Street Address |
280 N MAIN ST |
| City | BOUNTIFUL |
| State | UT |
| Zip Code | 84010-6136 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609845775 | Spencer E. Richards | Neuromusculoskeletal Medicine, Sports Medicine | 280 N Main St, Bountiful, UT 84010-6136 | 2006-03-14 |
| 1811538697 | Tayler Jensen | Speech-Language Pathologist | 280 N Main St, Bountiful, UT 84010-6136 | 2019-10-03 |
| 1063973915 | Hailee Christensen | Speech-Language Pathologist | 280 N Main St, Bountiful, UT 84010-6136 | 2019-03-25 |
| 1033674973 | Jessica Elizabeth Sherman | Physical Therapist | 280 N Main St, Bountiful, UT 84010-6136 | 2019-02-05 |
| 1275004954 | Elaina Scott Gregerson | Physical Therapist | 280 N Main St, Bountiful, UT 84010-6136 | 2018-12-06 |
| 1083079909 | Marie Perkins | Specialist/Technologist | 280 N Main St, Bountiful, UT 84010-6136 | 2015-12-18 |
| 1164802203 | Anna Cole Mctish | Occupational Therapist | 280 N Main St, # 2, Bountiful, UT 84010-6136 | 2015-06-03 |
| 1679952352 | Michelle Nicole Dean | Specialist | 280 N Main St, Bountiful, UT 84010-6136 | 2015-05-27 |
| 1639519549 | Ashley Safsten | Speech-Language Pathologist | 280 N Main St, Bountiful, UT 84010-6136 | 2013-06-25 |
| 1639412208 | Megan Eidenshink Shelly | Occupational Therapist | 280 N Main St, Second Floor, Bountiful, UT 84010-6136 | 2013-04-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225699192 | Jessyca K Willie | Behavior Technician | 415 S. Medical Drive Suite D101, Bountiful, UT 84010 | 2019-06-21 |
| 1336634344 | Shanna Joy Jaggers | Social Worker | 2333 S 200 E, Bountiful, UT 84010 | 2018-06-22 |
| 1447773171 | Live Life Alarms | Emergency Response System Companies | 640 South 500 West, Bountiful, UT 84010 | 2017-07-25 |
| 1902328842 | Hailey Embley | Behavior Technician | 415 Medical Drive D 101, Bountiful, UT 84010 | 2017-07-12 |
| 1508318031 | Beverly Nielsen | Psychologist | 1001 Lakeview Drive, Bountiful, UT 84010 | 2016-11-01 |
| 1295287720 | Samantha Oslund | Speech-Language Pathologist | 415 Medical Dr Ste B102, Bountiful, UT 84010 | 2016-11-01 |
| 1750748273 | Jeremy Clark Morris | Dentist | 59 W 1600 N, Suite 110, Bountiful, UT 84010 | 2016-01-28 |
| 1629464706 | Shane James | Speech-Language Pathologist | 425 Medical Dr Ste 122, Bountiful, UT 84010 | 2015-04-15 |
| 1891186102 | Kenton Francis | Social Worker | 1355 North Main Street #1, Bountiful, UT 84010 | 2015-02-09 |
| 1205233855 | Modern Dental Professionals - Utah, PC | Dentist | 24 S. 500 West, #a, Bountiful, UT 84010 | 2014-11-25 |
| Find all providers in zip 84010 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417248873 | Sabine Koepf-shakib | Pediatrics | Bountiful Clinic, 390 North Main Street, Bountiful, UT 84010 | 2011-04-20 |
| 1992818819 | Bonnie B Feola | Pediatrics | 520 Medical Dr Ste 301, Bountiful, UT 84010-8927 | 2006-08-16 |
| 1215313283 | Busy Bee Pediatrics, Inc. | Pediatrics | 520 Medical Dr Ste 301, Bountiful, UT 84010-8927 | 2015-07-31 |
| 1194158964 | Karin Marie Asplund Lammert | Pediatrics | 390 N Main St, Bountiful, UT 84010-6046 | 2013-08-15 |
| 1891061594 | Jeffery M Sabey | Pediatrics | 390 N Main St, Bountiful, UT 84010 | 2012-03-27 |
| 1558633487 | Douglas R. Coombs, Md, Inc | Pediatrics | 520 Medical Dr, #301, Bountiful, UT 84010-4968 | 2012-02-08 |
| 1114217205 | Andrea P Edwards | Pediatrics | 620 Medical Dr, Suite 100, Bountiful, UT 84010-5084 | 2011-04-11 |
| 1346494846 | Heather Fremgen Miller | Pediatrics | 390 N Main St, Bountiful, UT 84010-6046 | 2008-11-11 |
| 1750416947 | Ihc Health Services Inc | Pediatrics | 390 N Main St, Bountiful, UT 84010-6046 | 2007-02-21 |
| 1205977188 | Jonathan Milton Tew | Pediatrics | 620 Medical Dr, Suite 100, Bountiful, UT 84010-5084 | 2007-02-12 |
| Find all providers in BOUNTIFUL | ||||
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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.