Amanda Cannon

Primary specialty

Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X

License

5007198 Issued in NC

Practice address

101 E 2ND St
Kenly, NC 27542-7794

Phone

(919) 284-4025

Fax

(919) 284-5965

NPI assigned

Sep 23, 2014

Sex

Female

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

Enrolled in NC

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

Specialty

Nurse Practitioner

Education

Brody School of Medicine at East Carolina University, 2014

Medicare assignment

May accept Medicare assignment

Group practices

Comprehensive Rehab of Wilson, Inc.Group PAC ID 2668377375, 115 clinicians

Broad River RehabilitationGroup PAC ID 3375801350, 210 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Greenville, NC, CCN 347031
• Wilson Medical Center Hospital, Wilson, NC, CCN 340126

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amandacannon@kmac.allscriptsdirect.net

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.

• Kenly Medical Associates, PA

  • Internal Medicine Physician
  • Kenly, NC
  • NPI 1518075712
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  NC

  Medicare reassignment NPD
• Broad River Rehabilitation

  dba Broad River Rehab

  • Occupational Therapist
  • Charlotte, NC
  • NPI 1902317589
  Care Compare group
• Comprehensive Rehab of Wilson, Inc.

  • Physical Therapist
  • Wilson, NC
  • NPI 1861450884
  Care Compare group
• Vidant Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Greenville, NC
  • NPI 1477648731
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• DLP Wilson Medical Center LLC

  dba Wilson Medical Center

  • General Acute Care Hospital
  • Wilson, NC
  • NPI 1215359922
  Care Compare affiliation
• DLP Wilson Medical Center LLC

  dba Wilson Medical Center

  • Psychiatric Hospital Unit
  • Wilson, NC
  • NPI 1386196459
  Care Compare affiliation
• Eastern Carolina Home Health Agency, LLC

  dba CenterWell Home Health

  • Home Health Agency
  • Greenville, NC
  • NPI 1396775136
  Care Compare affiliation

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

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431561600000",
    "number": "1245632157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 275",
            "city": "KENLY",
            "state": "NC",
            "postal_code": "275420275",
            "telephone_number": "919-284-4025",
            "fax_number": "919-284-5965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E 2ND ST",
            "city": "KENLY",
            "state": "NC",
            "postal_code": "275427794",
            "telephone_number": "919-284-4025",
            "fax_number": "919-284-5965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-23",
        "last_updated": "2015-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "NC",
            "license": "5007198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anchorpoint Peer Support Services Agency
• Anchorpoint Peer Support Specialist Agency LLC
• Mary Langley Baker, RPH
• Joshua Scott Barnes, FNP-C
• Amelia Burns
• Kayla Cavenaugh
• Changing Grace Home Care, LLC
• Davis Drug Company of Kenly, Inc. (Davis Drug Company)
• Jerry Carl Davis, RPH
• Lynn L Davis

• Adult Health Clinical Nurse Specialist in Kenly, NC
• Providers in Kenly, NC by specialty
• Adult Health Clinical Nurse Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.