Individual provider Active NPI

Mary Cannon, APRN

  • Family Nurse Practitioner
  • Ocala, FL
National Provider Identifier
1831747369
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11003823 Issued in FL
Practice address
1015 SE 17TH St
Ocala, FL 34471-3968
Phone
(352) 843-2607
NPI assigned
Aug 28, 2019
Last updated
Aug 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11003823 FL Primary

Addresses

Primary practice location

1015 SE 17TH St
Ocala, FL 34471-3968

Mailing address

1015 SE 17TH St
Ocala, FL 34471-3968
Phone (352) 843-2607

Other names 1

  • Mary Parker Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20200602002222 FL Practitioner - Nurse Practitioner 2860813607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Drlullaby, LLCGroup PAC ID 9931507290, 7 clinicians

Practice addresses (Care Compare)

9701 NE 2ND Ave
Suite 1208
Miami Shores, FL 33138-2310
Phone (844) 475-3379

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Drlullaby LLC CurrentSince Aug 11, 2023 Accepting new patients

Locations

9701 NE 2nd Ave
Miami Shores, FL 33138
Phone (645) 201-9707

Organizations & group practices 1

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": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1831747369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 SE 17TH ST",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344713968",
            "telephone_number": "352-843-2607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 SE 17TH ST",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344713968",
            "telephone_number": "352-843-2607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-28",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11003823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "PARKER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ocala, FL

Sources for this page

Verify at the official NPI Registry.