KATRINA TERESE CANNON MD MS CMD NPI 1184734451

NPI Information

NPI: 1184734451
Provider Name: KATRINA TERESE CANNON, MD, MS, CMD
Classification: Internal Medicine - 207RG0300X
Entity Type: Individual

Specialization: Geriatric Medicine

Address:
1345 W CENTRAL PARK AVE
GENESIS FAMILY MEDICINE CENTER
DAVENPORT, IA
ZIP 52804
Phone: (563) 421-4400
Get Directions

Katrina Terese Cannon, MD, MS, CMD is a geriatric medicine internal medicine in Davenport, IA. The provider is an internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. Katrina Terese Cannon, MD, MS, CMD NPI is 1184734451. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1345 W CENTRAL PARK AVE
GENESIS FAMILY MEDICINE CENTER
DAVENPORT, IA
ZIP 52804-844
Phone: (563) 421-4400
Fax: (563) 421-4449

The enumeration date for this NPI number is 8/30/2006 and was last updated on 8/1/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207R00000X	Internal Medicine		35725	IOWA	No
2	207RG0300X	Internal Medicine	Geriatric Medicine	35725	IOWA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	I62684	MEDICARE UPIN
2	26710	OTHER	IOWA	WELLMARK BCBS
3	I18470	MEDICARE PIN	IOWA
4	0732552	MEDICAID	IOWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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