NPIMap

Organization Active NPI

Cannon Memorial Hospital

Doing business as AnMed ENT - Clemson

  • Otolaryngology Physician
  • Clemson, SC
National Provider Identifier
1295267227
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
CANNON MEMORIAL HOSPITAL
Doing business as
AnMed ENT - Clemson
Practice address
885 Tiger Blvd Ste a
Clemson, SC 29631-1480
Phone
(864) 897-0390
Fax
(864) 897-0391
NPI assigned
Mar 29, 2017
Last updated
Aug 11, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
ANMEDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Authorized official

Name
Mr. Michael Cunningham
Title
Ceo
Phone
(864) 512-1109

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X NU Primary

Addresses

Primary practice location

885 Tiger Blvd Ste a
Clemson, SC 29631-1480

Mailing address

PO Box 100174
Columbia, SC 29202-3174
Phone (864) 716-7750

Other practice location 1

123 Wg Acker Dr Ste B
Pickens, SC 29671-2739
Phone (864) 878-2435

Other names 1

  • AnMed ENT - Clemson Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040315000489 SC Part B Supplier - Clinic/Group Practice 8123930666 Receives reassigned benefits from 21 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clemson, SC; Easley, SC; Pickens, SC

Other NPIs on the same Medicare enrollment 6

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
Part of
Anmed Health Clemson Family Medicine

Other organizations with this tax ID 12

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

  • Anmed
    • Student in an Organized Health Care Education/Training Program
    • Anderson, SC
    • NPI 1821837238
    NPPES parent name

Practitioners & affiliated clinicians

Practitioners 1

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": "1490745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660176000000",
    "number": "1295267227",
    "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": "864-716-7750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 TIGER BLVD STE A",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296311480",
            "telephone_number": "864-897-0390",
            "fax_number": "864-897-0391"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 Wg Acker Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Pickens",
            "state": "SC",
            "postal_code": "296712739",
            "country_code": "US",
            "telephone_number": "864-878-2435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CANNON MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ANMED",
        "enumeration_date": "2017-03-29",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A",
        "authorized_official_last_name": "CUNNINGHAM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "864-512-1109",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AnMed ENT - Clemson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clemson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; 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.