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Cannon Memorial Hospital

Organization Active NPI General Acute Care Hospital · Pickens, SC

NPI 1497744254 · NPPES record last updated Sep 15, 2022

Key facts

NPI
1497744254
Entity type
Organization (NPI type 2)
Primary specialty
General Acute Care Hospital 282N00000X
License
HTL-076 (SC)
Legal business name
CANNON MEMORIAL HOSPITAL
Practice address
123 W G Acker Dr
Pickens, SC 29671-2739
Phone
(864) 878-4791
Fax
(864) 898-1047
NPI assigned
Oct 14, 2005
Organization subpart
No

Authorized official

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

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 12

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

Facilities connected through Provider of Services related, parent or unit certification numbers.

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners 59

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 59

Affiliated clinicians 100

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 100

Medicare Care Compare: Hospital

Listed as
Cannon Memorial Hospital CCN 420011
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D0253148Cannon Memorial Hospital
123 W G Acker Dr, Pickens, SC 29671		AccreditationJan 2, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in SC

Hospital certification: CCN 420011

Legal name
CANNON MEMORIAL HOSPITAL
Doing business as
ANMED CANNON
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jan 19, 2021
Beds
55
Ownership / control type
Private (not for profit)
Organization structure
Corporation · Non-profit
Incorporated
Dec 27, 1950 in SC
Enrollment address
123 WG Acker Dr
Pickens, SC 29671-2739
Main/Primary Hospital Location
Hospital subgroups
Acute care

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Linda Cassell
Individual 		Corporate Officer
Board Member		 Jan 1, 2011
Stephen J Grigsby
Individual 		Corporate Director Apr 28, 2025
Robert Bradley Mock
Individual 		Corporate Officer
Board Member		 Jan 1, 2019
Michael Cunningham
Individual 		W-2 Managing Employee
Cfo		 Jun 1, 2021
Operational/Managerial Control Jun 1, 2021
Harold Alexander
Individual 		Corporate Director Feb 28, 2022
Zachary Hinton
Individual 		Corporate Officer
Board Member		 Mar 25, 2019
William Kenley
Individual 		Corporate Officer
Anmed Health Ceo		 Sep 21, 2020
Corporate Director Sep 21, 2020
Scott Wesikittle
Individual 		Corporate Director Aug 29, 2022
Cannon Memorial Hospital
Organization · Pickens, SC
Corporation 		5% Or Greater Direct Ownership Interest Jan 1, 2014 100%
Operational/Managerial Control Jan 1, 2014 100%

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Anmed Primary Care - Easley
Easley, SC · CCN 423457		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2014
Jan 1, 2014
Anmed Primary Care - Liberty
Liberty, SC · CCN 423462		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2014
Jan 1, 2014

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040115000729 SC Part B Supplier - Clinic/Group Practice 8123930666 Receives reassigned benefits from 45 practitioners
1 other NPI on this enrollment
Practice locations: Pickens, SC
O20080519000081 SC Part a Provider - Hospital 8123930666 Practice locations: Pickens, SC

National Provider Directory

Tax ID family
Cannon Memorial Hospital (13 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X HTL-076 SC Yes

Addresses

Primary practice location

123 W G Acker Dr
Pickens, SC 29671-2739

Mailing address

123 W G Acker Dr
Pickens, SC 29671-2739
Phone (864) 898-4791

Other identifiers

IdentifierTypeStateIssuer
205007MedicaidSC
400113MedicaidSC
4200011MedicaidNC
89066XHMedicaidNC
CM6374OtherSCMEDICARE RAILROAD
42-U011OtherSCMEDICARE SWING BED UNIT
420011OtherSCMEDICARE I/P & O/P
420011OtherSCMEDICARE INPATIENT
300017386AMedicaidGA
382878MedicaidSC

Other names

  • AnMed Cannon Doing business as

Other providers in Pickens, SC

All providers in Pickens, SC · General Acute Care Hospital in South Carolina

Sources for this page

Verify at the official NPI Registry.