MRS. LILLIAN DEANN CANNON (PA) – Physician Assistant, NPI 1174875991

MRS. LILLIAN DEANN CANNON (PA) is a healthcare provider. based in Casper, Wyoming. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. The NPI Number for MRS. LILLIAN DEANN CANNON (PA) is 1174875991

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
MRS. LILLIAN DEANN CANNON (PA)
NPI
1174875991
Phone
(307) 234-6161
Address
1522 E A ST
Enumeration Date
3 October 2012
Last Update Date
23 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3072336000
Graduation Year
2012 (14 years ago)
PAC ID
3870733868
Group Practice PAC ID
3375454705
Professional Enrollment ID
I20130716000531
Address ID
WY826093345CA5000XRDXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:13State licenses:0Digital endpointsOther names

323 PHYSICIAN ASSISTANT in WY

Provider Addresses for MRS. LILLIAN DEANN CANNON (PA)

  • 1522 E A ST

    CASPER, WY 826012217

    Phone: (307) 234-6161

    Fax: (307) 234-7032

    Type: Mailing

  • 5000 Blackmore Rd

    Casper, WY 826093345

    Phone: (307) 233-6000

    Fax: (307) 233-6089

    Type: Location

  • 2241 FARNUM ST STE 105

    CASPER, WY 826094108

    Phone: (307) 295-7288

    Fax: (307) 333-1352

    Type: Mailing

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: 2013-07-16

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
I20130716000531IPhysician AssistantWYTBD

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 82601)

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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: 3375454705View full group profile
NameSpecialtyState
Physician AssistantWY
Nurse PractitionerWY
Clinical Social WorkerWY
Clinical Social WorkerWY
Nurse PractitionerWY
Nurse PractitionerWY
Nurse PractitionerWY
Family PracticeWY
Nurse PractitionerWY
Physician AssistantWY

Reviews

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Frequently asked questions

What is the registry number for MRS. LILLIAN DEANN CANNON (PA)?
The registry entry for MRS. LILLIAN DEANN CANNON (PA) shows NPI 1174875991.
Should I treat MRS. LILLIAN DEANN CANNON (PA) as an active provider?
Patients and plans typically see MRS. LILLIAN DEANN CANNON (PA) as active in the national extract.
What services align with MRS. LILLIAN DEANN CANNON (PA)'s listing?
MRS. LILLIAN DEANN CANNON (PA)'s public classification highlights Physician Assistant. Clinical services aligned with this taxonomy classification.
Can patients visit MRS. LILLIAN DEANN CANNON (PA) in Casper, Wyoming?
For routing, start with Casper, Wyoming for MRS. LILLIAN DEANN CANNON (PA), then verify phone and hours locally.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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