Mary Melissa Cannon, ARNP
Individual provider Active NPI Family Nurse Practitioner · Cedar Rapids, IA
NPI 1174209647 · NPPES record last updated Jun 27, 2023
Key facts
- NPI
- 1174209647
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- F06231826 (IA)
- Practice address
- 701 10TH St SE
Cedar Rapids, IA 52403-1251 - Phone
- (319) 398-6011
- NPI assigned
- Jun 27, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mercy Physician Associates Inc
Mercy Care Management, Inc
Practice addresses (Care Compare)
1790 Blairs Ferry Rd
Hiawatha, IA 52233-2033
Phone (319) 378-8362
2815 Edgewood Rd SW
Mercycare South
Cedar Rapids, IA 52404-3258
Phone (319) 396-9097
3701 Katz Dr
Marion, IA 52302-3871
Phone (319) 377-3174
5264 Council St NE
100 Mercycare North
Cedar Rapids, IA 52402-2477
Phone (319) 221-8444
Hospital & facility affiliations
- Mercy Home Care
- Mercy Medical Center - Cedar Rapids
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230830002718 | IA | Practitioner - Nurse Practitioner | 5092178624 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F06231826 | IA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Care Management, Inc | Family | Current |
Accepting new patients |
| Mercy Care Management, Inc | Family | Current |
Accepting new patients |
| Mercy Physician Associates, Inc | Current |
Accepting new patients | |
| Mercy Physician Associates Inc | Current |
Accepting new patients | |
| Mercy Physician Associates, Inc | Current | Accepting new patients | |
| Mercy Physician Associates, Inc | Past | Accepting new patients |
Locations
701 10th St SE
Cedar Rapids, IA 52403
Phone (319) 398-6011
5264 Council St NE
Ste 100
Cedar Rapids, IA 52402
Phone (319) 221-8444
1790 Blairs Ferry Rd
Hiawatha, IA 52233
Phone (319) 378-8362
300 W May St
Marengo, IA 52301
Phone (319) 462-8011
3701 Katz Dr
Marion, IA 52302
Phone (319) 373-3022
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F06231826 | IA | Yes |
Addresses
Primary practice location
701 10TH St SE
Cedar Rapids, IA 52403-1251
Mailing address
1269 Tramore Rd
Marion, IA 52302-6106
Phone (319) 538-4428
Other providers in Cedar Rapids, IA
- Cam F. Campbell
- Carrie Ann Campbell
- Hector M Candelaria II
- Jennifer Cannon
- Kristin Cannon
- Susan Cano
- Angela Annette Cantrell Fielding
- Jacqueline Christine Carder
- Cardiologists LC
- Cardiologists, P.C.
All providers in Cedar Rapids, IA · Family Nurse Practitioner in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.