Organization Active NPI

Cannon Family Medicine

  • Point of Service
  • Kannapolis, NC
National Provider Identifier
1255399374
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
117123 Issued in NC
Legal business name
CANNON FAMILY MEDICINE
Practice address
1035 Dale Earnhardt Blvd
Kannapolis, NC 28083-4481
Phone
(704) 933-2266
Fax
(704) 933-5954
NPI assigned
May 1, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Natalia B Caggiano
Title
Busniess Manager
Phone
(704) 933-2266

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X 117123 NC Primary

Addresses

Primary practice location

1035 Dale Earnhardt Blvd
Kannapolis, NC 28083-4481

Mailing address

1035 Dale Earnhardt Blvd
Kannapolis, NC 28083-4481
Phone (704) 933-2266

Other identifiers 1

IdentifierTypeStateIssuer
89015VWMedicaidNC

National Provider Directory

National Provider Directory

Locations

1035 Dale Earnhardt Blvd
Kannapolis, NC 28083
Phone (704) 316-1886

1035 Dale Earnhardt Blvd
Ste 121
Kannapolis, NC 28083
Phone (704) 933-2266

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255399374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 DALE EARNHARDT BLVD",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280834481",
            "telephone_number": "704-933-2266",
            "fax_number": "704-933-5954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 DALE EARNHARDT BLVD",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280834481",
            "telephone_number": "704-933-2266",
            "fax_number": "704-933-5954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANNON FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CAGGIANO",
        "authorized_official_first_name": "NATALIA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "BUSNIESS MANAGER",
        "authorized_official_telephone_number": "704-933-2266",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "NC",
            "license": "117123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89015VW",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kannapolis, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.