NPIMap

Organization Active NPI

Cannon Memorial Hospital

Doing business as AnMed Cannon

  • Emergency Medicine Physician
  • Pickens, SC
National Provider Identifier
1245930064
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
CANNON MEMORIAL HOSPITAL
Practice address
123 WG Acker Dr
Pickens, SC 29671-2739
Phone
(864) 878-4791
NPI assigned
Mar 9, 2023
Last updated
Mar 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Authorized official

Name
Christine Marie Pearson
Title
VP, Cfo
Phone
(864) 512-1104

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Primary
Physician Assistant 363A00000X
Certified Registered Nurse Anesthetist 367500000X

Addresses

Primary practice location

123 WG Acker Dr
Pickens, SC 29671-2739

Mailing address

PO Box 100174
Columbia, SC 29202-3174
Phone (864) 878-4791

Other names 1

  • AnMed Cannon Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040115000729 SC Part B Supplier - Clinic/Group Practice 8123930666 Receives reassigned benefits from 45 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pickens, SC

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Cannon Mem Hosp13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3722 Clemson Blvd
Ste A
Anderson, SC 29621
Phone (864) 231-7373

101 Pickens Dr
Liberty, SC 29657
Phone (864) 383-0384

105 Liberty Blvd
Liberty, SC 29657
Phone (800) 825-6688

123 Wg Acker Dr
#C
Pickens, SC 29671
Phone (864) 716-6149

Practitioners & affiliated clinicians

Practitioners 53

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 53

NPI Registry JSON

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

{
    "created_epoch": "1678320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678665600000",
    "number": "1245930064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100174",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292023174",
            "telephone_number": "864-878-4791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 WG ACKER DR",
            "city": "PICKENS",
            "state": "SC",
            "postal_code": "296712739",
            "telephone_number": "864-878-4791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANNON MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-09",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A",
        "authorized_official_last_name": "PEARSON",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "VP, CFO",
        "authorized_official_telephone_number": "864-512-1104"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AnMed Cannon",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AnMed Cannon",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pickens, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.