NPIMap

Individual provider Active NPI

Cannon James Woodbury

  • Emergency Medicine Physician
  • Dallas, TX
National Provider Identifier
1154909018
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
U7082 Issued in TX
Practice address
7777 Forest LN
Dallas, TX 75230-2571
Phone
(972) 566-7000
NPI assigned
Mar 31, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X U7082 TX Primary

Addresses

Primary practice location

7777 Forest LN
Dallas, TX 75230-2571

Mailing address

7777 Forest LN
Dallas, TX 75230-2571
Phone (972) 566-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240725001029 TX Practitioner - Emergency Medicine 3072913938 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Texas a & M University System, HSC, College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Concord Medical Group of Texas PLLCGroup PAC ID 7810117223, 319 clinicians

Practice addresses (Care Compare)

215 Chisholm TRL
Jacksboro, TX 76458-1403
Phone (940) 567-6633

Hospital & facility affiliations

  • Medical City Dallas Hospital Hospital, Dallas, TX, CCN 450647
  • Bsa Hospital Hospital, Amarillo, TX, CCN 450231
  • Medical City Las Colinas Hospital, Irving, TX, CCN 450822
  • Faith Community Hospital Hospital, Jacksboro, TX, CCN 450241

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Acs Primary Care Physicians Southwest, PA Emergency Medicine CurrentSince Dec 1, 2025 Accepting new patients
Questcare Medical Services, PLLC Emergency Medicine Current Accepting new patients
Concord Medical Group PLLC Emergency Medicine Current Accepting new patients
United Regional Health Care System Inc Current Accepting new patients
Questcare Medical Services, PLLC Emergency Medicine CurrentSince May 18, 2024 Accepting new patients
Concord Medical Group of Texas PLLC Emergency Medicine CurrentSince Dec 29, 2024 Accepting new patients

Locations

200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241

7777 Forest Ln
Dallas, TX 75230
Phone (972) 566-7283

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

215 Chisholm Trl
Jacksboro, TX 76458
Phone (940) 567-5528

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115

1600 11th St
Wichita Falls, TX 76301
Phone (940) 263-3000

Interoperability endpoints

  • FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/fhir/r4/
  • Direct secure messaging: cwoodbury78752@unitedregional.medalliesdirect.net
  • FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1154909018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302571",
            "telephone_number": "972-566-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302571",
            "telephone_number": "972-566-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODBURY",
        "first_name": "CANNON",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-31",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "U7082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.