Philip John Cannon, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

029853 Issued in GA

Practice address

1000 Medical Center Blvd
Lawrenceville, GA 30045-7694

Phone

(678) 442-3317

Fax

(678) 442-4416

NPI assigned

Feb 27, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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 Medicine

State licenses

Practice roles

Locations

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.

• Angelfish Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Covington, GA
  • NPI 1407259500
  Medicare reassignment NPD
• Gwinnett Emergency Specialists Observation Services, LLC

  • Emergency Medicine Physician
  • Lawrenceville, GA
  • NPI 1720373129
  Medicare reassignment NPD
• Gwinnett Emergency Specialists, LLC

  • Emergency Medicine Physician
  • Lawrenceville, GA
  • NPI 1437346467
  Medicare reassignment NPD
• Northside Emergency Associates, LLC

  • Emergency Medicine Physician
  • Sandy Springs, GA
  • NPI 1285686303
  Medicare reassignment NPD

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194852392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1466 PEACHTREE BATTLE AVE NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303271426",
            "telephone_number": "678-442-3317",
            "fax_number": "678-442-4416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MEDICAL CENTER BLVD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300457694",
            "telephone_number": "678-442-3317",
            "fax_number": "678-442-4416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "PHILIP",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "029853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00361292E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marie Donalde Candy, NP-C
• Daniel Brandon Caneda, MSW
• Harvietta Elaine Cannick
• Canning Chiropractic LLC
• Christopher Canning, BSC, DC
• Dawn Cannova, NNP-BC
• Gwen Cantrell, H.I.S
• Claire Capobianco, LCSW
• Paige Capponi
• Capri Homecare LLC

• Emergency Medicine Physician in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Emergency Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.