Eric Justin Cannon

Primary specialty

Private VehicleTaxonomy code 347C00000X

License

347C00000X Issued in SC

Practice address

632 King Ave
Florence, SC 29501-4331

Phone

(843) 453-2891

Fax

(843) 662-1995

NPI assigned

Nov 30, 2009

Last updated

Nov 30, 2009By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1259539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259539200000",
    "number": "1518295740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7246",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295027246",
            "telephone_number": "843-453-2891",
            "fax_number": "843-662-1995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 KING AVE",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014331",
            "telephone_number": "843-453-2891",
            "fax_number": "843-662-1995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "ERIC",
        "middle_name": "JUSTIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-30",
        "last_updated": "2009-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "SC",
            "license": "343900000X",
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "SC",
            "license": "347C00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORS- OFFICE OF REGULATORY STAFF",
            "identifier": "PCS/ORS 8156",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Delayna Campbell
• William Bradley Campbell, MD
• Hope Camper, RN, BSN
• Cynthia Ann Canarina, PT DPT
• Barbara Canelon, MOTR/L
• Fred Reeves Cannon III, M.A., LPC, BCPCC
• Sydney Cannon
• Tommy Lee Cantrell, D.M.D.
• Kylie Perkins Capdevila, F.N.P
• Shaquanna Capers

• Private Vehicle in Florence, SC
• Providers in Florence, SC by specialty
• Private Vehicle in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.