Jerry Cannaday, DO

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

R-4722 Issued in AR

Practice address

121 Cordoba Center Dr
Suite 400
Hot Springs, AR 71909-4030

Phone

(501) 915-0837

Fax

(501) 915-0978

NPI assigned

May 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2554/brand/4/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.

• Arkansas Healthcare Services LLC

  • Urology Physician
  • Hot Springs, AR
  • NPI 1174582621
  Medicare reassignment NPD

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484265600000",
    "number": "1194774646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 CORDOBA CENTER DR",
            "address_2": "SUITE 400",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719094030",
            "telephone_number": "501-915-0837",
            "fax_number": "501-915-0978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 CORDOBA CENTER DR",
            "address_2": "SUITE 400",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719094030",
            "telephone_number": "501-915-0837",
            "fax_number": "501-915-0978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNADAY",
        "first_name": "JERRY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2017-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "D7542",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AR",
            "license": "R-4722",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "R-4722",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "84Z865",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1341125-04",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "080095891",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rodrigo T Camacho, APRN
• James Willoughby Campbell, M.D.
• Lisa Denise Campbell, OTR L
• Mary Jane Campbell, CRNA
• John Campo, CRT
• Barbara M Cannon, RN
• Brandi Cannon, MHPP
• Kate J Cannon, MHPP
• Linda Birch Cannon, LCSW
• Tanya Cannon

• General Practice Physician in Hot Springs, AR
• Providers in Hot Springs, AR by specialty
• General Practice Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2017; 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.