Individual provider Active NPI

Jordan Cannon, AU.D

  • Audiologist
  • Augusta, GA
National Provider Identifier
1356220982
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AUD004478 Issued in GA
Practice address
1215 George C Wilson Dr Ste 3a
Augusta, GA 30909-5703
Phone
(346) 291-2206
Fax
(346) 291-2206
NPI assigned
Aug 28, 2025
Last updated
Nov 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AUD004478 GA Primary
Audiologist 231H00000X 30004476 NC
Hearing Instrument Specialist 237700000X AUD004478 GA

Addresses

Primary practice location

1215 George C Wilson Dr Ste 3a
Augusta, GA 30909-5703

Mailing address

1215 George C Wilson Dr Ste 3a
Augusta, GA 30909-5703
Phone (346) 291-2206

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251216003854 GA Practitioner - Qualified Audiologist 1052806163 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2501 Cottontail LN
Somerset, NJ 08873-5125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
30004476NCMDAudiologist
AUD004478GAMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Services Company USA, LLC Audiologist CurrentSince Dec 1, 2025 Accepting new patients
Audiology Services Company USA, LLC CurrentSince Dec 1, 2025 Accepting new patients

Locations

860 Duluth Hwy
Ste 330
Lawrenceville, GA 30043
Phone (470) 870-7234

4402 Lawrenceville Rd
Ste 225
Loganville, GA 30052
Phone (470) 268-5338

300 Creekstone Rdg
Woodstock, GA 30188
Phone (678) 225-8838

2501 Cottontail Ln
Somerset, NJ 08873
Phone (732) 529-7120

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1756339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1356220982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 GEORGE C WILSON DR STE 3A",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309095703",
            "telephone_number": "346-291-2206",
            "fax_number": "346-291-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 GEORGE C WILSON DR STE 3A",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309095703",
            "telephone_number": "346-291-2206",
            "fax_number": "346-291-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "AU.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-28",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "GA",
            "license": "AUD004478",
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NC",
            "license": "30004476",
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "GA",
            "license": "AUD004478",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.