Ross Michael Canup, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101263009 Issued in VA

Practice address

42D Medical Group
300 S. Twining St. BLDG 760
Maxwell Afb, AL 36112-6027

Phone

(334) 953-5200

Fax

(334) 953-8607

NPI assigned

Jun 17, 2016

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Uniformed Services Uhs Fe Hebert School of Med, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospital Physician Services - Southeast Professional CorporationGroup PAC ID 5597774554, 825 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Medical Center South Hospital, Montgomery, AL, CCN 010023

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hospital Physician Services - Southeast Professional Corporation

  • Hospitalist Physician
  • Monroe, GA
  • NPI 1760410385

  AL

  Medicare reassignment Care Compare group NPD
• Health Care Authority for Baptist Health, an Affiliate of Uabhs

  • General Acute Care Hospital
  • Montgomery, AL
  • NPI 1700977105
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Health Care Authority for Baptist Health, an Affiliate of Uabhs

  • General Acute Care Hospital
  • Montgomery, AL
  • NPI 1700977105
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1466121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1013367333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42D MEDICAL GROUP",
            "address_2": "300 S. TWINING ST. BLDG 760",
            "city": "MAXWELL AFB",
            "state": "AL",
            "postal_code": "361126027",
            "telephone_number": "334-953-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42D MEDICAL GROUP",
            "address_2": "300 S. TWINING ST. BLDG 760",
            "city": "MAXWELL AFB",
            "state": "AL",
            "postal_code": "361126027",
            "telephone_number": "334-953-5200",
            "fax_number": "334-953-8607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANUP",
        "first_name": "ROSS",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-17",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101263009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA MEDICAL LICENSE",
            "identifier": "0101263009",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Katherine Brincks, DDS
• Heather Marie Brooks, DDS
• Megan Bryant
• John Campbell Jr.
• Lauren Candee, PA-C
• Kenneth Michael Carter, PT, DPT
• Lori Dawn Carver, ARNP
• Ardis G. Cecil, PH.D.
• Francetta D. Childers, CRNP
• Hannah Clendening

• Family Medicine Physician in Maxwell Afb, AL
• Providers in Maxwell Afb, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.