CLARE ELIZABETH GANNON (FNP-C) – Nurse Practitioner, NPI 1114801008

CLARE ELIZABETH GANNON (FNP-C) is a healthcare provider. based in Minneapolis, Minnesota. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. 13175 (MN). The NPI Number for CLARE ELIZABETH GANNON (FNP-C) is 1114801008

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
CLARE ELIZABETH GANNON (FNP-C)
NPI
1114801008
Phone
(507) 284-2511
Address
PO BOX 860912
Enumeration Date
4 August 2025
Last Update Date
17 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5072388555
Graduation Year
2025 (1 year ago)
PAC ID
5193220267
Group Practice PAC ID
4981694981
Professional Enrollment ID
I20250929000656
Address ID
MN560314575FA800XXDRXX400

Contacts

Secure Messaging
cgannon348976@ehrdirect.mayoclinicmsg.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience29
Completeness95
Years active:0State licenses:1Other names

5,720 NURSE PRACTITIONER in MN

Provider Addresses for CLARE ELIZABETH GANNON (FNP-C)

  • PO BOX 860912

    MINNEAPOLIS, MN 554860912

    Phone: (507) 284-2511

    Type: Mailing

  • 1025 MARSH ST

    MANKATO, MN 560014752

    Phone: (570) 625-4031

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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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: 2025-09-29

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
I20250929000656INurse PractitionerMNTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55486)

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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: 4981694981View full group profile
NameSpecialtyState
-MN
-MN
-MN
Diagnostic RadiologyMN
Cardiovascular Disease (Cardiology), Advanced Heart Failure And Transplant CardiologyMN
Emergency MedicineOH
O P T O M E T R YMN
-MO
Family PracticeMN
Diagnostic RadiologyMN

Reviews

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Frequently asked questions

Is there an official ID for CLARE ELIZABETH GANNON (FNP-C) in U.S. healthcare records?
The official identifier for CLARE ELIZABETH GANNON (FNP-C) is NPI 1114801008.
Would CLARE ELIZABETH GANNON (FNP-C) appear as active to a payer?
You can treat CLARE ELIZABETH GANNON (FNP-C) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe CLARE ELIZABETH GANNON (FNP-C)'s focus?
For CLARE ELIZABETH GANNON (FNP-C), the primary taxonomy reads as Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where in Minnesota is CLARE ELIZABETH GANNON (FNP-C) registered?
Use Minneapolis, Minnesota as the headline location for CLARE ELIZABETH GANNON (FNP-C) here.
When was this NPI issued?
Enumeration for CLARE ELIZABETH GANNON (FNP-C) is noted as August 4, 2025 where the registry provides it.

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