Brett H Cannon, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

046053 Issued in GA

Practice address

8954 Hospital Dr
Douglasville, GA 30134-2272

Phone

(770) 920-6420

NPI assigned

Aug 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 7

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency MedicineAlso: Critical Care (Intensivists)

Education

University of North Carolina at Chapel Hill School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Bortolazzo Group, LLCGroup PAC ID 3476554320, 98 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar Douglas Medical Center Hospital, Douglasville, GA, CCN 110184

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

• The Bortolazzo Group, LLC

  • Emergency Medicine Physician
  • Austell, GA
  • NPI 1801965082
  Medicare reassignment Care Compare group NPD
• Georgia Emergency Group, LLC

  • Emergency Medicine Physician
  • Griffin, GA
  • NPI 1952746638
  Medicare reassignment NPD
• Lagrange Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Lagrange, GA
  • NPI 1760437560
  Medicare reassignment NPD
• North Fulton Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Roswell, GA
  • NPI 1053456954
  Medicare reassignment NPD
• Wellstar Medical Group, LLC

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment NPD
• Columbia County Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Grovetown, GA
  • NPI 1972461044
  NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• Chest Pain Observation, PLLC

  • Hospitalist Physician
  • Memphis, TN
  • NPI 1063752319

  Emergency Medicine

  NPD
• Emerginet Henry, LLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Atlanta, GA
  • NPI 1811946627
  NPD (past)
• Emerginet, LLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Atlanta, GA
  • NPI 1164480869
  NPD (past)
• Morningside Emergency Physicians LLC

  • Emergency Medicine Physician
  • Perry, GA
  • NPI 1114975521
  NPD (past)
• Parkway Anesthesia Consultants, PC

  • Certified Registered Nurse Anesthetist
  • Villa Rica, GA
  • NPI 1194887455
  NPD (past)

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

• Douglas Hospital, Inc.

  • General Acute Care Hospital
  • Douglasville, GA
  • NPI 1649247974
  Care Compare affiliation

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1124132386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5665 NEW NORTHSIDE DR NW",
            "address_2": "SUITE 320",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285831",
            "telephone_number": "770-874-5400",
            "fax_number": "770-874-5469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8954 HOSPITAL DR",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342272",
            "telephone_number": "770-920-6420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "BRETT",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "046053",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101236067",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "200301097",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "15230R",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "MD.25283",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00866115I",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00866115K",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00866115J",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051559698",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7559160",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00866115L",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "051542477",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Robinson Camp, D.C.
• Cori Campbell, BCBA
• Katherine L Campbell, CSA
• Jennifer Canada McKnight, DMD
• Chris Cancino
• Cassandra Lichkay Cannon, DMD
• Capri Medical Center
• Care From the Heart Private Home Care LLC
• Care Team Health Solutions
• Care Team Health Solutions

• Emergency Medicine Physician in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Emergency Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; 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.