NPIMap

Individual provider Active NPI

Heather Cannon, M.D.

  • Family Medicine Physician
  • Philadelphia, MS
National Provider Identifier
1801082409
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22698 Issued in MS
Practice address
1122 E Main St
Suite 4
Philadelphia, MS 39350-2348
Phone
(601) 656-1001
Fax
(601) 656-7555
NPI assigned
Sep 18, 2007
Last updated
Jul 21, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 22698 MS Primary
Family Medicine Physician 207Q00000X 29398 AL

Addresses

Primary practice location

1122 E Main St
Suite 4
Philadelphia, MS 39350-2348

Mailing address

1122 E Main St
Suite 4
Philadelphia, MS 39350-2348
Phone (601) 656-1001

Other identifiers 1

IdentifierTypeStateIssuer
03123057MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150527000339 MS Practitioner - Family Practice 6103014642 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Alabama School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neshoba County General HospitalGroup PAC ID 6204738289, 30 clinicians

Practice addresses (Care Compare)

1001 Holland Ave
Philadelphia, MS 39350-2161
Phone (601) 663-1200

1001 Holland Aveneu
Philadelphia, MS 39350-2161

1002 Saint Francis Dr
Philadelphia, MS 39350-2030
Phone (601) 663-1200

1003 Hollad Ave
Philadelphia, MS 39350-2180
Phone (601) 663-1234

406 Stribling St
Philadelphia, MS 39350-3344
Phone (601) 656-9183

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Neshoba County General Hospital CurrentSince Feb 1, 2023 Accepting new patients
Neshoba County General Hospital CurrentSince Feb 1, 2023 Accepting new patients
Neshoba County General Hospital Current Accepting new patients
Neshoba Physicians Billing Service CurrentSince Dec 30, 2014 Accepting new patients
Neshoba County General Hospital Family Medicine Current Accepting new patients
Neshoba Physician Billing Service CurrentSince Dec 30, 2014 Accepting new patients
Neshoba Family Medical Clinic PastSince Mar 1, 2020 Accepting new patients
Neshoba County General Hospital Past Accepting new patients
Neshoba County General Hospital Past Accepting new patients

Locations

1001 Holland Ave
Philadelphia, MS 39350
Phone (601) 663-1200

1003 Holland Ave
Ste 101
Philadelphia, MS 39350
Phone (601) 663-1234

Interoperability endpoints

  • Direct secure messaging: heathercannon@neshobahealth.cernerdirect.com

Organizations & group practices 9

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 5

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": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437436800000",
    "number": "1801082409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 E MAIN ST",
            "address_2": "SUITE 4",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393502348",
            "telephone_number": "601-656-1001",
            "fax_number": "601-656-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 E MAIN ST",
            "address_2": "SUITE 4",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393502348",
            "telephone_number": "601-656-1001",
            "fax_number": "601-656-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "HEATHER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-18",
        "last_updated": "2015-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "22698",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "29398",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03123057",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, MS

Sources for this page

Verify at the official NPI Registry.