Kelly Cannon, APRN, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN11005031 Issued in FL

Practice address

1700 S 23Rd St
Fort Pierce, FL 34950-4803

Phone

(772) 461-4000

NPI assigned

Aug 14, 2019

Last updated

Oct 23, 2024By the provider in NPPES

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FJEICA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emergency Medicine Services of FL, LLC

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1043917180
  Medicare reassignment NPD
• FL-I Medical Services, LLC

  • Nurse Practitioner
  • Fort Pierce, FL
  • NPI 1750655106
  Medicare reassignment NPD
• Jupiter Medical Center Physicians Group Inc

  • Cardiovascular Disease Physician
  • Jupiter, FL
  • NPI 1396992475
  Medicare reassignment NPD
• MD Now Medical Centers Inc

  • Urgent Care Clinic/Center
  • West Palm Beach, FL
  • NPI 1033195474
  Medicare reassignment NPD
• Michele F Libman MD PA

  dba Treasure Coast Urgent Care

  • Urgent Care Clinic/Center
  • Stuart, FL
  • NPI 1255410288
  Medicare reassignment NPD
• FL-I Medical Services LLC

  • Physician Assistant
  • Haines City, FL
  • NPI 1285356790

  Nurse Practitioner

  NPD
• FL-I Medical Services, LLC

  • Emergency Medicine Physician
  • Orlando, FL
  • NPI 1306417654
  NPD
• Jupiter Medical Center Physicians Group

  dba Jupiter Medical Center Urgent Care

  • Urgent Care Clinic/Center
  • Jupiter, FL
  • NPI 1013314285
  NPD
• Jupiter Medical Center Physicians Group Inc

  dba JMC Community Care

  • Pediatric Surgery Physician
  • Jupiter, FL
  • NPI 1093344376
  NPD
• MD Now Medical Centers Inc

  dba MD Now Urgent Care

  • Urgent Care Clinic/Center
  • Pembroke Pines, FL
  • NPI 1265107361
  NPD
• Paragon Contracting Services LLC

  • Emergency Medicine Physician
  • Birmingham, AL
  • NPI 1225071459

  Nurse Practitioner

  NPD

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

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1184270209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 JUPITER LAKES BLVD STE 4105",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334587190",
            "telephone_number": "561-743-9938",
            "fax_number": "561-575-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S 23RD ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504803",
            "telephone_number": "772-461-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "KELLY",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-14",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11005031",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "FL",
            "license": "RN9312491",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "e11343@jupitermed.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "2628 SE Federal Hwy",
            "city": "Stuart",
            "state": "FL",
            "country_code": "US",
            "postal_code": "349944535",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "KramosAPRN@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "210 Jupiter Lakes Blvd Ste 4105",
            "city": "Jupiter",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334587190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Beverly Campbell
• Kelly Marie Campbell, APRN
• Richard Naugle Campbell, MS, LMHC
• Robert Dwight Campbell, MSW
• Naty Canales
• Nicole D Canterella, PMHNP, BC
• Jalyssa Cardell
• Irma Cardenosa Garcia, RBT
• Vanessa Cardis
• Care One Support LLC

• Nurse Practitioner in Fort Pierce, FL
• Providers in Fort Pierce, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.