DAVID CANNON (OD) – Optometrist, NPI 1487630133

DAVID CANNON (OD) is a healthcare provider. based in Traverse city, Michigan. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. DC00295 (MI). The NPI Number for DAVID CANNON (OD) is 1487630133

Main info

Male
44 Years Of Experience
Accepts Medicare Assignment
Name
DAVID CANNON (OD)
NPI
1487630133
Phone
(231) 941-5440
Address
3200 S AIRPORT RD W
Enumeration Date
15 December 2005
Last Update Date
29 July 2011

Doctor Profile

Medical School Name
FERRIS STATE COLLEGE - COLLEGE OF OPTOMETRY
Secondary Phone
-
Graduation Year
1982 (44 years ago)
PAC ID
1850386350
Group Practice PAC ID
2466447966
Professional Enrollment ID
I20111209000565
Address ID
MI496842204Tr336XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,204 OPTOMETRY in MI

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Provider Addresses for DAVID CANNON (OD)

  • West South Airport Road, Traverse City, Grand Traverse County, Michigan, 49686, United States

    #146

    TRAVERSE CITY, MI 496848117

    Phone: (231) 941-5440

    Fax: (231) 941-0893

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $57.

Total Amount is formed as General ($57) + Research ($0) + Ownership ($0) = $57.

Last reported payment date: 2024-02-09 • Largest payer in this snapshot: Johnson & Johnson Vision Care, Inc. ($57).

Total Amount

$57

General + Research + Ownership

Payments

2

Total payment records

General Amount

$57

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-02-09

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2011-12-09

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
I20111209000565IOptometryMITBD

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
99213Established patient office or other outpatient visit, 20-29 minutes9587$0
66984Removal of cataract with insertion of prosthetic lens2012$0
99203New patient office or other outpatient visit, 30-44 minutes1414$0
View full utilization report →

Insurance plans in this area (ZIP 49684)

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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: 2466447966View full group profile
NameSpecialtyState
O P T O M E T R YMI
O P T O M E T R YMI
O P T O M E T R YMI
O P T O M E T R YMI
O P T O M E T R YMI
O P T O M E T R YMI
O P T O M E T R YMI

Reviews

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Frequently asked questions

How do payers reference DAVID CANNON (OD)?
For DAVID CANNON (OD), use NPI 1487630133 as the unique 10-digit identifier.
Is DAVID CANNON (OD) still an active registrant?
DAVID CANNON (OD) carries an active NPI according to the public dataset.
What area of care is associated with DAVID CANNON (OD)?
DAVID CANNON (OD)'s record emphasizes Optometrist. Clinical services aligned with this taxonomy classification.
Where in Michigan is DAVID CANNON (OD) registered?
Use Traverse City, Michigan as the headline location for DAVID CANNON (OD) here.
Can I trust this NPI listing for DAVID CANNON (OD)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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