Robert David Cannon, M.D.

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

C-8066 Issued in AR

Practice address

1708 E Joyce Blvd Ste 2
Fayetteville, AR 72703-5250

Phone

(479) 582-2800

Fax

(479) 582-2922

NPI assigned

Jan 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Interventional Pain ManagementAlso: Anesthesiology

Education

University of Arkansas College of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Circle of Life Hospice Hospice, Springdale, AR, CCN 041529
• Washington Regional Medical Center Hospital, Fayetteville, AR, CCN 040004
• Siloam Springs Regional Hospital Hospital, Siloam Springs, AR, CCN 040001
• Northwest Medical Center-Springdale Hospital, Springdale, AR, CCN 040022

Merit-based Incentive Payment System (MIPS)

Final score

94.86 of 100Reported as group

Quality

82.89

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cannon.robert.014.0030038@nsc.meditab.direct-ci.com

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.

• Circle of Life

  • Community Based Hospice Care Agency
  • Springdale, AR
  • NPI 1386755460
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Circle of Life

  • Community Based Hospice Care Agency
  • Springdale, AR
  • NPI 1386755460

  Hospice

  Care Compare affiliation
• Northwest Arkansas Hospitals, LLC

  • General Acute Care Hospital
  • Springdale, AR
  • NPI 1699726695

  Hospital

  Care Compare affiliation
• Siloam Springs Arkansas Hospital Company LLC

  • General Acute Care Hospital
  • Siloam Springs, AR
  • NPI 1902051816

  Hospital

  Care Compare affiliation
• Washington Regional Medical Center

  • General Acute Care Hospital
  • Fayetteville, AR
  • NPI 1083609150

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1104806702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 E JOYCE BLVD STE 2",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035250",
            "telephone_number": "479-582-2800",
            "fax_number": "479-582-2922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 E JOYCE BLVD STE 2",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035250",
            "telephone_number": "479-582-2800",
            "fax_number": "479-582-2922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "ROBERT",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "AR",
            "license": "C8066",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "AR",
            "license": "C-8066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127592001",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rdavidcannonmd@rdc.azelea.phimailbox.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1708 E Joyce Blvd Ste 2",
            "city": "Fayetteville",
            "state": "AR",
            "country_code": "US",
            "postal_code": "727035250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Sara Louise Campbell, LPC
• Sarah Anne Campbell, DNP, AGAC-BC
• Kevin Bryce Campos, DC
• Candor Clinicians PA
• Michele Yvette Cantu, MD
• Capital Anesthesia Solutions of Arkansas, LLC
• Jennifer D Capps
• John A Capwell, MHPP
• Cara Hartfield PHD Licensed Psychologist PLC

• All providers in Fayetteville, AR
• Interventional Pain Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; 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.