Louis James Cannella Jr., M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301040183 Issued in MI

Practice address

2009 10TH St
Menominee, MI 49858-2105

Phone

(906) 863-8853

NPI assigned

Jan 26, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Upper Peninsula Association of Rural Health Services, Inc.

  • Family Medicine Physician
  • Marquette, MI
  • NPI 1396851804

  Family Medicine

  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1043366313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2009 10TH ST",
            "city": "MENOMINEE",
            "state": "MI",
            "postal_code": "498582105",
            "telephone_number": "906-863-8853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2009 10TH ST",
            "city": "MENOMINEE",
            "state": "MI",
            "postal_code": "498582105",
            "telephone_number": "906-863-8853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNELLA",
        "first_name": "LOUIS",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301040183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4387698",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katie Broeders, LLBSW
• Barbara A Brown, RN, BSN
• Michelle Brownson
• Suzanne Brzykcy, LLP, CMHP/QMHP
• Crystalee Christine Caley
• Angela J Carlson, RPH
• Opal Lynn Carlson
• Danielle Cech
• Amanda Champagne
• Changing Seasons Counseling Center

• All providers in Menominee, MI
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.