Mary Jo Cannon, MD

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

D28907 Issued in MD

Practice address

8945 N Westland Dr
Gaithersburg, MD 20877-1249

Phone

(301) 330-0006

NPI assigned

Feb 7, 2013

Sex

Female

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 MD, DC2 enrollments

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 2

Specialty

Family PracticeAlso: Addiction Medicine

Education

University of Maryland School of Medicine, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• KP Enterprises, Inc

  • Clinic/Center
  • Cumberland, MD
  • NPI 1356165740
  Medicare reassignment NPD
• More With Doc C, LLC

  • Addiction Psychiatry Physician
  • Cumberland, MD
  • NPI 1346736626
  NPD (past) Authorized official
• Cumberland Emergency Medical Group PA

  • Emergency Medicine Physician
  • Cumberland, MD
  • NPI 1275639932
  NPD (past)
• Cumberland Emergency Medical Group, PA

  • Emergency Medicine Physician
  • Cumberland, MD
  • NPI 1417132481
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Mary Jo Cannon MD

  • Adult Day Care Clinic/Center
  • Gaithersburg, MD
  • NPI 1942512942
  NPD (past)

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

{
    "created_epoch": "1360195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1619216835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20909 SUNNYACRES RD",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208821248",
            "telephone_number": "240-330-2430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8945 N WESTLAND DR",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208771249",
            "telephone_number": "301-330-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "MARY JO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-07",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "MD",
            "license": "D28907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Briana Campbell
• Karina Campbell
• Melissa Jeannette Campbell
• Raqia Archee Campbell
• Kate Campion
• Nyah Yasmeen Canty
• Ariel Capili, MD
• Capital Neuro Care PA
• Capital Primary Care Inc
• Capital Region Surgical Assistants LLC

• Addiction Medicine (Family Medicine) Physician in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Addiction Medicine (Family Medicine) Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.