Cannon Ridge Diagnostic, LLC

Primary specialty

Phlebotomy TechnicianTaxonomy code 246RP1900X

Legal business name

CANNON RIDGE DIAGNOSTIC, LLC

Practice address

11560 NC 55 Hwy Ste 7
Grantsboro, NC 28529-9447

Phone

(252) 242-0088

Fax

(252) 631-0340

NPI assigned

Jun 29, 2020

Last updated

Jun 29, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Eric Cannon

Title

Owner

Phone

(252) 617-7974

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Renita Kirkman

  • In Home Supportive Care Agency
  • Grantsboro, NC
  • NPI 1164058186
  NPD

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

{
    "created_epoch": "1593388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593388800000",
    "number": "1033736822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 MAGNOLIA WAY",
            "city": "GRANTSBORO",
            "state": "NC",
            "postal_code": "285299457",
            "telephone_number": "252-617-7974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11560 NC 55 HWY STE 7",
            "city": "GRANTSBORO",
            "state": "NC",
            "postal_code": "285299447",
            "telephone_number": "252-242-0088",
            "fax_number": "252-631-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANNON RIDGE DIAGNOSTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-29",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-617-7974"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Jeffery Achterberg, COTA/L
• Casey Bennington-Palmer
• Britthaven, Inc. (Britthaven of Pamlico)
• Carolina Home Medical, Inc (Carolina Home Medical)
• Tessa Clark
• Robert Malachi Clements, PTA
• Amanda Michelle Cline-Grant, DC, FNP-BC
• Continuum II Home Health & Hospice, Inc. (Continuum Home Care of Pamlico)

• Phlebotomy Technician in Grantsboro, NC
• Providers in Grantsboro, NC by specialty
• Phlebotomy Technician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.