CORA WHITNEY HANNON (M.D.) – Dermatology Physician, NPI 1164404018

CORA WHITNEY HANNON (M.D.) is a healthcare provider. based in Olympia, Washington. specializing in DERMATOLOGY. They hold the professional credentials M.D.. They hold a License No. A83814 (CA). The NPI Number for CORA WHITNEY HANNON (M.D.) is 1164404018

Main info

Female
28 Years Of Experience
Accepts Medicare Assignment
Name
CORA WHITNEY HANNON (M.D.)
NPI
1164404018
Phone
(360) 923-7430
Address
700 LILLY ROAD NE
Enumeration Date
16 November 2005
Last Update Date
22 March 2022

Doctor Profile

Medical School Name
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO SCHOOL OF MEDICINE
Secondary Phone
3865883138
Graduation Year
1998 (28 years ago)
PAC ID
3678470317
Professional Enrollment ID
I20220520000316
Address ID
FL326156579AL16181441X501
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

393 DERMATOLOGY in WA

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Provider Addresses for CORA WHITNEY HANNON (M.D.)

  • Kaiser Permanente Olympia Medical Center, 700, Lilly Road Northeast, Olympia, Thurston County, Washington, 98506, United States

    OLYMPIA MEDICAL CENTER GROUP HEALTH DEPARTMENT OF DERMA

    OLYMPIA, WA 98506

    Phone: (360) 923-7430

    Type: Location

  • West Newberry Road, Newberry Little Farms, Waterford Township, Oakland County, Michigan, 48329, United States

    NEWBERRY, FL 326692765

    Phone:

    Type: Mailing

  • 16181 NW US HIGHWAY 441 UNIT 170

    ALACHUA, FL 326156579

    Phone: (386) 588-3138

    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: 2022-05-20

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
I20220520000316IDermatologyFLTBD

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 98506)

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Reviews

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Frequently asked questions

What is CORA WHITNEY HANNON (M.D.)'s NPI number?
CORA WHITNEY HANNON (M.D.)'s NPI is 1164404018 — the number used across U.S. healthcare to identify this provider.
Would CORA WHITNEY HANNON (M.D.) appear as active to a payer?
You can treat CORA WHITNEY HANNON (M.D.) as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is CORA WHITNEY HANNON (M.D.)?
CORA WHITNEY HANNON (M.D.) is associated with Dermatology Physician in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with CORA WHITNEY HANNON (M.D.)?
Directory geography for CORA WHITNEY HANNON (M.D.) centers on Olympia, Washington.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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