Emily Bordeleau Cannon, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86119367 Issued in NC

Practice address

721-D Malcom Blvd
Rutherford College, NC 28671

Phone

(828) 455-1699

NPI assigned

Sep 16, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Burke Primary Care LLCGroup PAC ID 1759339948, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73177

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.

• Burke Primary Care, LLC

  • Family Medicine Physician
  • Morganton, NC
  • NPI 1225085707

  NC

  Medicare reassignment Care Compare group NPD

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": []
}

• Blue Ridge Healthcare Medical Group, Inc.
• Blue Ridge Healthcare Medical Group, Inc.
• Blue Ridge Healthcare Medical Group, Inc.
• Blue Ridge Healthcare Medical Group, Inc.
• Kerry Wendell Byrd, MD
• Jeffrey Van Clontz, PHARMD
• James Bryan Cox, DO
• Albert R Cujas Jr., LPT
• Christopher Thomas Daley, MD
• Dalsania & Associates, PLLC

• Registered Dietitian in Rutherford College, NC
• Providers in Rutherford College, NC by specialty
• Registered Dietitian in North Carolina

• 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.

Verify at the official NPI Registry.