Zachary G. Cannon, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

Q2747 Issued in TX

Practice address

1000 E 5TH St
Tyler, TX 75701-3346

Phone

(903) 596-3862

Fax

(903) 590-5005

NPI assigned

Jul 5, 2011

Last updated

Jan 25, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in TX

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

• Direct secure messaging: zcannon354995@ahs.direct-ci.com

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.

• Etmc Physician Group Inc.

  • Cardiovascular Disease Physician
  • Tyler, TX
  • NPI 1609382662
  Medicare reassignment NPD
• Etmc Physician Group Inc.

  • Rural Health Clinic/Center
  • Chandler, TX
  • NPI 1235706581
  NPD
• Starks Medical

  • Primary Care Nurse Practitioner
  • Bullard, TX
  • NPI 1306570593
  NPD (past)

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

{
    "created_epoch": "1309824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453680000000",
    "number": "1457648974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E 5TH ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013346",
            "telephone_number": "903-596-3862",
            "fax_number": "903-590-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E 5TH ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013346",
            "telephone_number": "903-596-3862",
            "fax_number": "903-590-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "ZACHARY",
        "middle_name": "G.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-05",
        "last_updated": "2016-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q2747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candy Cares
• Jonathan Canion, MD
• Marla Cannefax, M.S., LSSP, LPC
• Clay Cannon
• Emily J Cannon, ACNP
• Valerie Marie Cano, DDS
• Arnulfo Cantu
• Hayley Cantway, MD
• Jessica Lynn Cantwell, PHARMD
• Lan Cao, PHARMD

• Pediatrics Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; 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.