Jacob Harrison Cannon

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

50482 Issued in SC

Practice address

194 Jacobs Hwy
Clinton, SC 29325-7276

Phone

(864) 833-5000

NPI assigned

Oct 6, 2022

Last updated

May 26, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1665014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1194440750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 BEULAH LN",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290639573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 JACOBS HWY",
            "city": "CLINTON",
            "state": "SC",
            "postal_code": "293257276",
            "telephone_number": "864-833-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "JACOB",
        "middle_name": "HARRISON",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-06",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "SC",
            "license": "50482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Byron a Brown MD LLC
• Jacquelyn Denise Calhoun
• Judy Allyene Calvert, RN
• Brenda T Campbell
• Johnny Eugene Campbell II
• Louvenia Carlie
• Geoffrey Carlson, PA
• Carolina Christian Ministrties (Bailey Manor Christian Retirement Community)
• Carolina Counseling Associates of the Upstate
• Carolina Family Medicine of Laurens County PA

• Student in an Organized Health Care Education/Training Program in Clinton, SC
• Providers in Clinton, SC by specialty
• Student in an Organized Health Care Education/Training Program in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.