Individual provider Active NPI

Jessica Cannon, PA

  • Surgical Physician Assistant
  • Omaha, NE
National Provider Identifier
1710426549
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
2109 Issued in NE
Practice address
8005 Farnam Dr Ste 305
Omaha, NE 68114-3426
Phone
(402) 390-4111
Fax
(402) 390-4115
NPI assigned
Feb 13, 2017
Last updated
Oct 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 2109 NE Primary

Addresses

Primary practice location

8005 Farnam Dr Ste 305
Omaha, NE 68114-3426

Mailing address

8005 Farnam Dr Ste 305
Omaha, NE 68114-3426
Phone (402) 390-4111

Other practice location 1

222 N 192nd St
Elkhorn, NE 68022-5363
Phone (402) 390-4111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170214001382 NE Practitioner - Physician Assistant 7416230602 Reassigns benefits to 1 organization
I20200807002090 IA Practitioner - Physician Assistant 7416230602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD West One PCGroup PAC ID 0446228852, 89 clinicians

Practice addresses (Care Compare)

1 Edmundson PL
Suite 200
Council Bluffs, IA 51503-4658
Phone (402) 390-4111

2959 US Hwy 275
Hamburg, IA 51640-5052
Phone (402) 390-4111

7915 Farnam Dr
Omaha, NE 68114-4504
Phone (402) 399-1900

8005 Farnam Dr
Suite 305
Omaha, NE 68114-3426
Phone (402) 390-4111

8303 Dodge St
Omaha, NE 68114-4108
Phone (402) 354-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.57 of 100Reported as group
Quality
76.1
Promoting interoperability
95
Improvement activities
40
Cost
76.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MD West One, PC Surgical CurrentSince Mar 13, 2017 Accepting new patients
MD West One, PC CurrentSince Mar 13, 2017 Accepting new patients

Locations

1 Edmundson Pl
Ste 200
Council Bluffs, IA 51503
Phone (712) 243-3250

2959 US Highway 275
Hamburg, IA 51640
Phone (316) 644-5393

222 N 192nd St
Elkhorn, NE 68022

3301 E Elkhorn Dr
Ste 100
Fremont, NE 68025
Phone (402) 721-0090

17030 Lakeside Hills Plz
Ste 200
Omaha, NE 68130
Phone (402) 399-8550

5908 S 142nd St
Omaha, NE 68137
Phone (402) 354-1900

7710 Mercy Rd
Ste 224
Omaha, NE 68124
Phone (402) 399-8550

8005 Farnam Dr
Ste 305
Omaha, NE 68114

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1710426549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8005 FARNAM DR STE 305",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143426",
            "telephone_number": "402-390-4111",
            "fax_number": "402-390-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8005 FARNAM DR STE 305",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143426",
            "telephone_number": "402-390-4111",
            "fax_number": "402-390-4115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 N 192nd St",
            "address_purpose": "LOCATION",
            "city": "Elkhorn",
            "state": "NE",
            "postal_code": "680225363",
            "country_code": "US",
            "telephone_number": "402-390-4111",
            "fax_number": "402-390-4115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANNON",
        "first_name": "JESSICA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-13",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NE",
            "license": "2109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.