Benjamin Chad Cannon, CPRS

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

License

L000000027637 Issued in TN

Practice address

2408 Susannah St
Johnson City, TN 37601-1732

Phone

(423) 434-6677

NPI assigned

Oct 5, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1633392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1275205437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 E LAKEVIEW DR",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011866",
            "telephone_number": "423-530-8309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2408 SUSANNAH ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011732",
            "telephone_number": "423-434-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "BENJAMIN",
        "middle_name": "CHAD",
        "name_prefix": "Mr.",
        "credential": "CPRS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-05",
        "last_updated": "2021-10-05",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "TN",
            "license": "L000000027637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Hope Campbell, DPT
• Linda Campbell, RBT
• Makensey Campbell, DDS
• Nelea Dotson Campbell, MSN, APRN, FNP-C
• Cancer Outreach Associates of Tennessee, P.C.
• Cathlyn Carole Cannon, L.P.C. MHSP
• Elizabeth Forgey Cannon, DDS
• Jennifer Leigh Cannon, FNP
• Brittany M Cantrell, P.A.
• McKayla Cantrell, CCC-SLP

• Addiction Medicine (Internal Medicine) Physician in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Addiction Medicine (Internal Medicine) Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; 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.