Active NPI
Emily Bordeleau Cannon, RDN
- Registered Dietitian
- Rutherford College, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86119367
- Practice address
- 721-D Malcom Blvd
Rutherford College, NC 28671 - Phone
- (828) 455-1699
- NPI assigned
- Sep 16, 2020
- Last updated
- Sep 16, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Education Nutritionist | 133NN1002X | 86119367 | NC | |
| Registered Dietitian | 133V00000X | 86119367 | NC | Primary |
Addresses
Primary practice location
721-D Malcom Blvd
Rutherford College, NC 28671
Mailing address
PO Box 308
Rutherford College, NC 28671-0308
Phone (828) 455-1699
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
103 Medical Heights Dr
Morganton, NC 28655-5197
Phone (828) 437-4211
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86119367 | NC | MD | Nutrition Education Nutritionist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Burke Primary Care, LLC | Current | Accepting new patients |
Locations
103 Medical Heights Dr
Morganton, NC 28655
Phone (828) 437-4211
149 W Parker Rd
Ste A
Morganton, NC 28655
Phone (828) 433-5550
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73177
Organizations & group practices 1
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 Medicine Physician
- Morganton, NC
- NPI 1225085707
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600214400000",
"number": "1104432160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 308",
"city": "RUTHERFORD COLLEGE",
"state": "NC",
"postal_code": "286710308",
"telephone_number": "828-455-1699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "721-D MALCOM BLVD",
"city": "RUTHERFORD COLLEGE",
"state": "NC",
"postal_code": "28671",
"telephone_number": "828-455-1699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANNON",
"first_name": "EMILY",
"middle_name": "BORDELEAU",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-16",
"last_updated": "2020-09-16",
"certification_date": "2020-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "133NN1002X",
"taxonomy_group": "",
"desc": "Nutritionist, Nutrition, Education",
"state": "NC",
"license": "86119367",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NC",
"license": "86119367",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rutherford College, NC
- Blue Ridge Healthcare Medical Group, Inc. (Blue Ridge Internal Medicine)
- Blue Ridge Healthcare Medical Group, Inc. (Mountain Orthopaedics)
- Blue Ridge Healthcare Medical Group, Inc. (Blue Ridge Internal Medicine)
- Blue Ridge Healthcare Medical Group, Inc. (Rutherford College Family Medical Care Center)
- Kerry Wendell Byrd, MD
- Jeffrey Van Clontz, PHARMD
- James Bryan Cox, DO
- Albert R Cujas Jr., LPT
- Christopher Thomas Daley, MD
- Dalsania & Associates, PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.