Jennifer Cannon, N.P.
Individual provider Active NPI Nurse Practitioner · Florence, OR
NPI 1699212779 · NPPES record last updated Apr 18, 2025
Key facts
- NPI
- 1699212779
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- NUR-APRN-LIC-180218 (MT)
- Practice address
- 380 9TH St
Florence, OR 97439-9470 - Phone
- (541) 997-7134
- Fax
- (541) 902-1320
- NPI assigned
- Jan 26, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Kalispell Regional Medical Center Inc
Practice addresses (Care Compare)
320 Sunnyview LN
Kalispell, MT 59901-3129
Phone (406) 756-3526
Hospital & facility affiliations
- Logan Health Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220317000130 | MT | Practitioner - Nurse Practitioner | 9133160476 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NUR-APRN-LIC-180218 | MT | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Glacier Regional Pathology, LTD. | Current | Accepting new patients | |
| Kalispell Regional Medical Center, Inc | Current |
Accepting new patients | |
| Kalispell Regional Medical Center Inc | Current | Accepting new patients | |
| Kalispell Regional Medical Center Inc | Current | Accepting new patients | |
| Kalispell Regional Medical Center, Inc | Current |
Accepting new patients | |
| Kalispell Regional Medical Center, Inc | Past | Accepting new patients |
Locations
350 Heritage Way
Ste 2100
Kalispell, MT 59901
Phone (406) 257-8992
320 Sunnyview Ln
Kalispell, MT 59901
Phone (406) 752-7441
310 Sunnyview Ln
Kalispell, MT 59901
Phone (406) 751-5310
Interoperability endpoints
- krmcmedicalrecords@krhdirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 11485 | CA | |
| Nurse Practitioner | 363L00000X | 201801167NP-PP | OR | |
| Nurse Practitioner | 363L00000X | NUR-APRN-LIC-180218 | MT | Yes |
Addresses
Primary practice location
380 9TH St
Florence, OR 97439-9470
Mailing address
260 Hospital Dr
Suite 207
Ukiah, CA 95482-4568
Other practice location 1
390 9th St
Florence, OR 97439-9470
Phone (541) 997-7134
Other practice location 2
260 Hospital Dr Ste 207
Ukiah, CA 95482-4568
Phone (707) 463-7627
Other practice location 3
320 Sunnyview Ln
Kalispell, MT 59901-3129
Phone (406) 756-3526
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | krmcmedicalrecords@krhdirect.org | Kalispell Regional Medical Center, Inc |
Other providers in Florence, OR
- Corey Burch
- Corey Ione Burgess
- Sarah Catherine Butte
- Cafe of Life Chiropractic at Florence, P.C.
- Vanessa Call
- Sharon F Catlin
- Thomas Anthony Caton
- Chad E. Clement, DDS, PC
- Charles W Korando, DDS, PC
- Eunlee Chung
All providers in Florence, OR · Nurse Practitioner in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 18, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.