Ericia Latrice Cannon, NURSE PRACTITONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

903107 Issued in MS

Practice address

3502 W Northside Dr
Jackson, MS 39213-4454

Phone

(601) 362-5321

NPI assigned

Feb 16, 2019

Last updated

Mar 7, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Health Care Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Pearl, MS
  • NPI 1043236326
  NPD
• Family Health Care Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Flowood, MS
  • NPI 1689440133
  NPD
• Horizon Medical Providers LLC

  • Family Medicine Physician
  • Ridgeland, MS
  • NPI 1982441473
  NPD
• Community Care Health Network LLC

  dba Matrix Medical Network

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1619368842
  NPD

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

{
    "created_epoch": "1550275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551916800000",
    "number": "1013473891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3502 W NORTHSIDE DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392134454",
            "telephone_number": "601-362-5321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3502 W NORTHSIDE DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392134454",
            "telephone_number": "601-362-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "ERICIA",
        "middle_name": "LATRICE",
        "credential": "NURSE PRACTITONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-16",
        "last_updated": "2019-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Canada
• Candid Mississippi, P.C.
• Ashley Miller Canizaro, M.D.
• Colleen G Cannon, CFNP
• D Timothy Cannon, M.D.
• Lauren Elizabeth Cantrell
• Meagan Cantrelle
• Christopher Thai Cao, PHARMD
• Capital City Children and Adolescent Clinic
• Capital City Endocrine Clinic LLC

• Family Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.