Charles Ron Cannon, MD

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

07635 Issued in MS

Practice address

1038 River Oaks Dr
Flowood, MS 39232

Phone

(601) 932-5244

Fax

(601) 939-0545

NPI assigned

Aug 30, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/7115/brand/1/csg/1/fhir/r4

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

• Independent Healthcare Management, Inc.

  • Critical Access Hospital
  • Forest, MS
  • NPI 1306909734
  Medicare reassignment NPD
• River Oaks Management Company LLC

  • Family Medicine Physician
  • Jackson, MS
  • NPI 1922029040
  Medicare reassignment NPD
• Careplus Lakeview Family Medicine

  • Family Medicine Physician
  • Clinton, MS
  • NPI 1942621024
  NPD
• Independent Healthcare Management, Inc.

  • Rural Health Clinic/Center
  • Newton, MS
  • NPI 1396118378
  NPD
• Independent Healthcare Management, Inc.

  • Rural Health Clinic/Center
  • Raleigh, MS
  • NPI 1871272724
  NPD
• Reservoir Family Medical Clinic, PA

  • Family Medicine Physician
  • Flowood, MS
  • NPI 1770929713
  NPD
• River Oaks Management Company, LLC

  • Otolaryngology Physician
  • Vicksburg, MS
  • NPI 1720372345
  NPD
• Head & Neck Surgical Group

  • Otolaryngology Physician
  • Flowood, MS
  • NPI 1841416070
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366761600000",
    "number": "1437269479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5345",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39296",
            "telephone_number": "601-932-5244",
            "fax_number": "601-939-0545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1038 RIVER OAKS DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "39232",
            "telephone_number": "601-932-5244",
            "fax_number": "601-939-0545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "CHARLES",
        "middle_name": "RON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "MS",
            "license": "07635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08553384",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Caine, RNFA
• David J Caldwell, D.M.D.
• Rosalie Ann Camacho-Collier, LICSW
• Camellia Pharmacy Services LLC
• Camellia Pharmacy Services LLC
• Whitney Canoy
• Capital Emergency Physicians PLLC
• Capital Hearing Center LLC
• Capital Hearing Services
• Capital Orthopaedic Clinic PLLC

• Otolaryngology/Facial Plastic Surgery Physician in Flowood, MS
• Providers in Flowood, MS by specialty
• Otolaryngology/Facial Plastic Surgery Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.