Sarah Cannon, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

D0085864 Issued in MD

Practice address

2012 S Tollgate Rd Ste 206
Bel Air, MD 21015

Phone

(410) 216-0202

NPI assigned

Jun 20, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Sep 24, 2018 through Sep 24, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1276992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554249600000",
    "number": "1821319229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 S TOLLGATE RD STE 206",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210155902",
            "telephone_number": "410-216-0202",
            "fax_number": "408-915-6337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2012 S TOLLGATE RD STE 206",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "21015",
            "telephone_number": "410-216-0202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 N Gilbert St",
            "address_2": "Suite 1201",
            "address_purpose": "LOCATION",
            "city": "Tinton Falls",
            "state": "NJ",
            "postal_code": "077014955",
            "country_code": "US",
            "telephone_number": "732-747-5500 x1004",
            "fax_number": "732-747-1212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANNON",
        "first_name": "SARAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-20",
        "last_updated": "2019-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MD",
            "license": "D0085864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Bel Air, MD
• Providers in Bel Air, MD by specialty
• Dermatology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.