Bernetta Cannon, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.025522 Issued in IL

Practice address

237 W 95TH St
Chicago, IL 60628-1321

Phone

(773) 468-2110

NPI assigned

Apr 5, 2023

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

Enrolled in IL

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Palos Medical Center PLLCGroup PAC ID 0244682110, 2 clinicians

Palos Urgent Care PLLCGroup PAC ID 9537510193, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Palos Medical Center PLLC

  • Primary Care Clinic/Center
  • Palos Hills, IL
  • NPI 1518741792
  Medicare reassignment Care Compare group NPD
• Palos Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Palos Hills, IL
  • NPI 1639953342
  Medicare reassignment Care Compare group NPD
• Medicare Physicians LTD

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1780197806
  NPD
• Northwest Medical and Urgent Care Center at Yale and 95TH LTD

  • Clinic/Center
  • Chicago, IL
  • NPI 1457864407
  NPD

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

{
    "created_epoch": "1680652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1891480950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 W 95TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606281321",
            "telephone_number": "773-468-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 W 95TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606281321",
            "telephone_number": "773-468-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "BERNETTA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-05",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.025522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adreana M Cannon
• Alexandra T Cannon, APRN, CNP
• Andrew Adam Cannon, M.D.
• Anisha Cannon
• Anthony John Cannon, M.D
• Desiray M Cannon
• Gloria A Cannon, SLP
• Hershel Warren Cannon, MD,MA
• Jennifer Jean Cannon, ANP-C
• Karen Cannon

• Family Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; 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.

Verify at the official NPI Registry.