Individual provider Active NPI

Lorraine Marie Cannon, CRNP

  • Acute Care Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1730963059
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
SP027672 Issued in PA
Practice address
3549 Brookview Rd
Philadelphia, PA 19154-4004
Phone
(267) 253-0168
NPI assigned
Aug 21, 2023
Last updated
Aug 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X SP027672 PA Primary

Addresses

Primary practice location

3549 Brookview Rd
Philadelphia, PA 19154-4004

Mailing address

3549 Brookview Rd
Philadelphia, PA 19154-4004
Phone (267) 253-0168

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20231102002062 PA Practitioner - Nurse Practitioner 0547616112 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Abington Rehabilitation Associates LLCGroup PAC ID 2466523881, 17 clinicians
Vitality NP Group LLCGroup PAC ID 1052747128, 12 clinicians

Practice addresses (Care Compare)

2510 Maryland Rd
Suite 150
Willow Grove, PA 19090-1143
Phone (215) 674-3337

45 Loggers Mill Rd
Horsham, PA 19044-1924
Phone (484) 433-9084

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP027672PAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vitality NP Group LLC CurrentSince Jun 1, 2025 Accepting new patients
Provider Partners Care Management LP CurrentSince Jul 1, 2025 Accepting new patients
Bridges Palliative Care LLC CurrentSince Oct 19, 2023 Accepting new patients

Locations

8820 Columbia 100 Pkwy
Ste 430
Columbia, MD 21045
Phone (317) 701-2379

685 River Ave
Unit 3
Lakewood, NJ 08701
Phone (732) 987-3855

401 Horsham Rd
Horsham, PA 19044
Phone (215) 422-3646

6212 Walnut St
Philadelphia, PA 19139
Phone (215) 476-6264

251 Stenton Ave
Plymouth Mtng, PA 19462
Phone (215) 987-3663

8833 Stenton Ave
Wyndmoor, PA 19038
Phone (215) 509-6826

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1730963059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3549 BROOKVIEW RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191544004",
            "telephone_number": "267-253-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3549 BROOKVIEW RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191544004",
            "telephone_number": "267-253-0168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "LORRAINE",
        "middle_name": "MARIE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP027672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.