NPIMap

Organization Active NPI

Cannon Memorial Hospital

Doing business as AnMed Health Cannon Medical Group Primary Care

  • Family Medicine Physician
  • Pickens, SC
National Provider Identifier
1821759796
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CANNON MEMORIAL HOSPITAL
Doing business as
AnMed Health Cannon Medical Group Primary Care
Practice address
123 WG Acker Dr
Pickens, SC 29671-2739
Phone
(864) 878-4791
NPI assigned
Jan 4, 2022
Last updated
Jan 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Authorized official

Name
Shon M Herron
Title
Financial Director
Phone
(864) 898-1151

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

123 WG Acker Dr
Pickens, SC 29671-2739

Mailing address

PO Box 100174
Columbia, SC 29202-3174
Phone (864) 878-4791

Other names 1

  • AnMed Health Cannon Medical Group Primary Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cannon Memorial Hospital13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1641254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641254400000",
    "number": "1821759796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100174",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292023174",
            "telephone_number": "864-878-4791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 WG ACKER DR",
            "city": "PICKENS",
            "state": "SC",
            "postal_code": "296712739",
            "telephone_number": "864-878-4791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANNON MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-04",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-03",
        "status": "A",
        "authorized_official_last_name": "HERRON",
        "authorized_official_first_name": "SHON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "FINANCIAL DIRECTOR",
        "authorized_official_telephone_number": "864-898-1151"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AnMed Health Cannon Medical Group Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pickens, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.