Active NPI
Matthew David Cannon, D.O.
- Family Medicine Physician
- Spartanburg, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- LL1020
- Practice address
- 853 N Church St Ste 510
Spartanburg, SC 29303-3077 - Phone
- (864) 560-6193
- Fax
- (864) 560-1510
- NPI assigned
- Oct 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | LL1020 | SC | Primary |
Addresses
Primary practice location
853 N Church St Ste 510
Spartanburg, SC 29303-3077
Mailing address
PO Box 743070
Atlanta, GA 30374-3070
Phone (864) 560-4304
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SC98233365 | Other | SC | MEDICARE PIN |
| 010204 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- West Virginia School of Osteopathic Medicine, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
101 E Wood St
Spartanburg, SC 29303-3040
Phone (864) 560-6193
Hospital & facility affiliations
- Spartanburg Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.7 of 100
- Quality
- 89.4
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL1020 | SC | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spartanburg Medical Center | Current | Accepting new patients | |
| Spartanburg Medical Center | Past | Accepting new patients |
Locations
101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915
101 E Wood St
Ste 300
Spartanburg, SC 29303
Phone (864) 560-6554
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Neuromusculoskeletal Medicine & OMM Physician
- Spartanburg, SC
- NPI 1043309917
-
- Obstetrics & Gynecology Physician
- Spartanburg, SC
- NPI 1376580852
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital Unit
- Spartanburg, SC
- NPI 1033681630
-
- General Acute Care Hospital
- Spartanburg, SC
- NPI 1609807122
-
- Rehabilitation Hospital Unit
- Spartanburg, SC
- NPI 1942772546
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1851472872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 743070",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303743070",
"telephone_number": "864-560-4304",
"fax_number": "864-560-4413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "853 N CHURCH ST STE 510",
"city": "SPARTANBURG",
"state": "SC",
"postal_code": "293033077",
"telephone_number": "864-560-6193",
"fax_number": "864-560-1510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANNON",
"first_name": "MATTHEW",
"middle_name": "DAVID",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-17",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SC",
"license": "LL1020",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PIN",
"identifier": "SC98233365",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010204",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Spartanburg, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.