MRS. LILLIAN DEANN CANNON PA
NPI 1174875991
Physician Assistant in Casper, WY
NPI Status: Active since October 03, 2012
Contact Information
2241 FARNUM ST STE 105
CASPER, WY
ZIP 82609
Phone: (307) 295-7288
Fax: (307) 333-1352
- Individual
- Female
- Years of Experience 14
- Physician Assistant
- Accepts Insurance
- Accepts Medicare Approved Payment
- Opted-Out Medicare
- Medicare Quality Reporting
About LILLIAN CANNON
This page provides the complete NPI Profile along with additional information for Lillian Cannon, a primary care provider established in Casper, Wyoming with a medical specialization in Physician Assistant and more than 14 years of experience. The healthcare provider is registered in the NPI registry with number 1174875991 assigned on October 2012. The practitioner's primary taxonomy code is 363A00000X. The provider is registered as an individual and her NPI record was last updated May 2025.
- NPI
- 1174875991
- Provider Name
- MRS. LILLIAN DEANN CANNON PA
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 2241 FARNUM ST STE 105 CASPER, WY 82609
- Location Phone
- (307) 295-7288
- Location Fax
- (307) 333-1352
- Mailing Address
- 2241 FARNUM ST STE 105 CASPER, WY 82609
- Mailing Phone
- (307) 295-7288
- Mailing Fax
- (307) 333-1352
- Medical School Name
- OTHER
- Graduation Year
- 2012
- Is Sole Proprietor?
- No
- Enumeration Date
- 10-03-2012
- Last Update Date
- 05-23-2025
- Code Navigator
A primary care provider (PCP) like Lillian Cannon sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Lillian Cannon opted out of Medicare effective on 07-01-2025 until 07-01-2027. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
Location Map
Secondary Locations
- 5000 Blackmore Rd
Casper, WY 82609
(307) 233-6000
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant
- Taxonomy Code
- 363A00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- Taxonomy Description
- A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BlueSelect Bronze Basic - PPO
- BlueSelect Bronze Core - PPO
- BlueSelect Expanded Bronze Standard without Kid's Dental - PPO
- BlueSelect Gold Core - PPO
- BlueSelect Gold HealthPlus - PPO
- BlueSelect Gold Standard without Kid's Dental - PPO
- BlueSelect Silver Classic - PPO
- BlueSelect Silver Classic without Kid's Dental - PPO
- BlueSelect Silver HealthPlus - PPO
- BlueSelect Silver HealthPlus without Kid's Dental - PPO
- BlueSelect Silver Standard without Kid's Dental - PPO
- Connect Bronze Expanded Standard - PPO
- Connect Bronze HDHP - PPO
- Connect Catastrophic - PPO
- Connect Gold - PPO
- Connect Gold Standard - PPO
- Connect Silver - PPO
- Connect Silver Standard - PPO
- High Plains Bronze HDHP - PPO
- High Plains Bronze Standard Expanded - PPO
- High Plains Gold - PPO
- High Plains Gold HDHP - PPO
- High Plains Gold Standard - PPO
- High Plains Silver - PPO
- High Plains Silver Standard - PPO
- Plus Bronze Expanded - PPO
- Plus Bronze Standard Expanded - PPO
- Plus Gold - PPO
- Plus Gold Standard - PPO
- Plus Silver Standard - PPO
- ACCESS BRONZE - PPO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Bronze Standard (No Referrals) - EPO
- UHC Bronze Value HSA (No Referrals) - EPO
- UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) - EPO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
- UHC Gold Standard (No Referrals) - EPO
- UHC Gold Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - EPO
- UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - EPO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
- UHC Silver Standard (No Referrals) - EPO
- UHC Silver Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Lillian Cannon is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 07-01-2025
Opt-Out End Date: 07-01-2027
Eligible to Order and Refer? Yes
PECOS PAC ID: 3870733868
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20130716000531
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Electronic submission of Patient Centered Medical Home accreditation | Yes | N/A |
| I attest that I am a Patient Centered Medical Home (PCMH) or Comparable Specialty Practice that has achieved certification from a national program, regional or state program, private payer, or other body that administers patient-centered medical home accreditation and should receive full credit for the Improvement Activities performance category. | ||
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 7 | 4 | 8 | 7 | 5 | 9 | 9 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 14 | 4 | 16 | 7 | 10 | 9 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 1 + 4 + 4 + 1 + 6 + 7 + 1 + 0 + 9 + 1 + 8 + 24 = 69 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 69 = 1 | 1 | ||||||||
The NPI number 1174875991 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1336976281 | VITALITY MEDICAL SOLUTIONS LLC Organization | Physician Assistant | 2241 FARNUM ST STE 105 CASPER, WY 82609 (307) 689-1831 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174875991, enumerated in the NPI registry as an "individual" on October 03, 2012
The provider is located at 2241 Farnum St Ste 105 Casper, Wy 82609 and the phone number is (307) 295-7288
The provider's speciality is Physician Assistant with taxonomy code 363A00000X
The provider has more than 14 years of experience.
The provider might be accepting Accepts: Blue Cross Blue Shield of Wyoming, Mountain Health. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
No, the provider signed an affidavit on July 01, 2025 to opt-out of the Medicare program. The provider is excluded from the Medicare program until July 01, 2027.
This NPI record was last updated on October 03, 2012. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.