GARY FANNON (P.A.) – Medical Physician Assistant, NPI 1447512819

GARY FANNON (P.A.) is a healthcare provider. based in Flint, Michigan. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials P.A.. The NPI Number for GARY FANNON (P.A.) is 1447512819

Main info

Male
14 Years Of Experience
Accepts Medicare Assignment
Name
GARY FANNON (P.A.)
NPI
1447512819
Phone
(810) 262-9683
Address
1 HURLEY PLZ
Enumeration Date
12 June 2012
Last Update Date
12 June 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5179136711
Graduation Year
2012 (14 years ago)
PAC ID
1759537202
Group Practice PAC ID
0648277830
Professional Enrollment ID
I20120815000813
Address ID
MI489123757LA1540XRDXX411
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience31
Completeness75
Years active:13State licenses:0Digital endpointsOther names

6,066 PHYSICIAN ASSISTANT in MI

Provider Addresses for GARY FANNON (P.A.)

  • 1 HURLEY PLZ

    FLINT, MI 485035902

    Phone: (810) 262-9683

    Fax: (810) 760-0440

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-08-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120815000813IPhysician AssistantMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes4241$0
87635Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen2121$0
81002Urinalysis, manual test1414$0
99215Established patient office or other outpatient visit, 40-54 minutes1313$0
99213Established patient office or other outpatient visit, 20-29 minutes1313$0
View full utilization report →

Insurance plans in this area (ZIP 48503)

Loading plans...

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0648277830View full group profile
NameSpecialtyState
Physician AssistantMI
Nurse PractitionerMI
-MI
Family PracticeMI
Physician AssistantOH
Emergency MedicineMI
Nurse PractitionerMI
Family PracticeMI
Emergency MedicineMI

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What is the registry number for GARY FANNON (P.A.)?
The registry entry for GARY FANNON (P.A.) shows NPI 1447512819.
Should I treat GARY FANNON (P.A.) as an active provider?
Patients and plans typically see GARY FANNON (P.A.) as active in the national extract.
What services align with GARY FANNON (P.A.)'s listing?
GARY FANNON (P.A.)'s public classification highlights Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
What geographic area is tied to GARY FANNON (P.A.)?
GARY FANNON (P.A.) is associated with Flint, Michigan in the same public data insurers reference.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

Similar Providers

MATTHEW A STACK (PA C)

Physician Assistant
East Warwick Drive, Alma, Gratiot County, Michigan, 48801, United States
NPI: 1033108667

STEPHANIE LYNN LAMONT (PAC)

Surgical Physician Assistant
7314 IRA LN
NPI: 1568415479

DENNIS LEE WALLACE (P.A.)

Medical Physician Assistant
Beecher Road, Flint, Genesee County, Michigan, 48433, United States
NPI: 1396790986

MR. STEVEN LEE GALLIWAY (PAC)

Medical Physician Assistant
2462 E HILL RD STE 2
NPI: 1346295094

DAVID HAMAKER (PA-C)

Medical Physician Assistant
5142, Miller Road, Swartz Creek, Flint Township, Genesee County, Michigan, 48507, United States
NPI: 1427092147

JAMES A ARCEO (PA C)

Surgical Physician Assistant
818 W KING ST STE 300
NPI: 1821032566

MISS CLARA C CARROLL (PA)

Medical Physician Assistant
East Grand River Road, Laingsburg, Shiawassee County, Michigan, 48848, United States
NPI: 1538190723

ALEESHA KILBREATH (PA-C)

Surgical Physician Assistant
1 HURLEY PLZ
NPI: 1003848623

REBEKAH KAY LANGE (PHYSICIAN ASSISTANT)

Medical Physician Assistant
2700, Robert T Longway Boulevard, Flint, Genesee County, Michigan, 48503, United States
NPI: 1720192099