S. Cannon Medical P.a.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

39059 Issued in NC

Legal business name

S. CANNON MEDICAL P.A.

Practice address

2402 S. Cannon Blvd.
Kannapolis, NC 28083

Phone

(704) 938-4886

Fax

(704) 938-5644

NPI assigned

Oct 18, 2006

Last updated

Sep 5, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. James M Peckinpaugh, MDNPI 1104907997

Title

President

Phone

(704) 938-4886

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

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.

• James Matthew Peckinpaugh, MD

  • Family Medicine Physician
  • Kannapolis, NC
  • NPI 1104907997
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220572800000",
    "number": "1467533257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2402 S. CANNON BLVD.",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "28083",
            "telephone_number": "704-938-4886",
            "fax_number": "704-938-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 S. CANNON BLVD.",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "28083",
            "telephone_number": "704-938-4886",
            "fax_number": "704-938-5644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S. CANNON MEDICAL P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2008-09-05",
        "status": "A",
        "authorized_official_last_name": "PECKINPAUGH",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-938-4886",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "39059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890189F",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8966442",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0189F",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dustin Allen Rubenstein, DMD
• Asia Chanell Ruiz-Smith, LCSWA
• Antonyia Lee Quinn Rumph, BSN
• Dalton Lee Russell
• Ryse Rebuilding Young Minds to Seek Excellence Development Corp
• S. Vakil DDS Ms VIII, PA (Growing Smiles Pediatric Dentistry- Kannapolis)
• Safe Haven Medical Supplies LLC
• Safrit PLLC (Family Dental Health of Concord Lake)
• Safrit PLLC (Family Dental Health of Kannapolis)
• Sage Alliance Inc

• Family Medicine Physician in Kannapolis, NC
• Providers in Kannapolis, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2008; 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.