Rubaba Cannon

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN242262 Issued in GA

Practice address

3621 Vinings Slope SE Unit 1332
Atlanta, GA 30339-4168

Phone

(404) 307-9691

NPI assigned

Jun 27, 2016

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

Enrolled in GA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Uhs of Anchor L.P.

  • Psychiatric Hospital
  • Stockbridge, GA
  • NPI 1952537920
  Medicare reassignment NPD
• Dekalb Community Service Board

  • Community/Behavioral Health Agency
  • Decatur, GA
  • NPI 1073686978
  Medicare reassignment
• Uhs of Anchor L.P.

  • Psychiatric Hospital
  • Atlanta, GA
  • NPI 1023095429
  NPD
• Transitional Family Sevices

  • Community/Behavioral Health Agency
  • Atlanta, GA
  • NPI 1972946218
  NPD (past)

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1073964458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 VININGS SLOPE SE UNIT 1332",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303394168",
            "telephone_number": "404-307-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3621 VININGS SLOPE SE UNIT 1332",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303394168",
            "telephone_number": "404-307-9691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "RUBABA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-27",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN242262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Cannon
• Laurel Cannon
• Linda Jean Cannon, MD
• Lucy Roberts Cannon, LCSW
• Robert Davis Cannon, RN, CNS
• Cannonier Psychological Center LLC
• Alfred Bates Canon, LPC
• Canopy Oaks Mental Health, LLC
• Elvin Canseco
• Allison Rose Cansler

• Psychiatric/Mental Health Nurse Practitioner in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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.