Amanda Graves Cannon, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9111041-4405 Issued in UT

Practice address

667 E 500 N Ste 200
Vineyard, UT 84059-6004

Phone

(801) 669-5758

Fax

(801) 216-8357

NPI assigned

Jul 12, 2018

Last updated

Nov 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Valley Obstetrics and Gynecology, PC

  • Obstetrics & Gynecology Physician
  • American Fork, UT
  • NPI 1588863377
  Medicare reassignment NPD
• Valley Obstetrics and Gynecology, P.C.

  • Advanced Practice Midwife
  • American Fork, UT
  • NPI 1780002188
  NPD
• Valley Obstetrics and Gynecology, PC

  dba South County Group

  • Obstetrics & Gynecology Physician
  • Spanish Fork, UT
  • NPI 1073187258
  NPD
• Draper Family Medical Associates, LLC

  • Family Medicine Physician
  • Draper, UT
  • NPI 1689893174
  NPD (past)
• Valley Obstetrics and Gynecology, PC

  dba Southern Utah Women's Health Center, PC

  • Obstetrics & Gynecology Physician
  • St George, UT
  • NPI 1568478170
  NPD (past)

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1760968804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 E 500 N STE 200",
            "city": "VINEYARD",
            "state": "UT",
            "postal_code": "840596004",
            "telephone_number": "801-669-5758",
            "fax_number": "801-216-8357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 E 500 N STE 200",
            "city": "VINEYARD",
            "state": "UT",
            "postal_code": "840596004",
            "telephone_number": "801-669-5758",
            "fax_number": "801-216-8357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 W 800 N Ste 200",
            "address_purpose": "LOCATION",
            "city": "Orem",
            "state": "UT",
            "postal_code": "840576316",
            "country_code": "US",
            "telephone_number": "016-695-7588",
            "fax_number": "801-216-8357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANNON",
        "first_name": "AMANDA",
        "middle_name": "GRAVES",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-12",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "UT",
            "license": "911041",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "9111041-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Devyn Arlie Darrohn, CNA
• Heeju Davis, RN

• Family Nurse Practitioner in Vineyard, UT
• Providers in Vineyard, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.