Individual provider Active NPI

Benjamin Seth Cannon

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1891492831
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11024408 Issued in FL
Practice address
1 Shircliff Way
Jacksonville, FL 32204-4748
Phone
(904) 308-7300
NPI assigned
Feb 9, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 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 APRN11024408 FL Primary

Addresses

Primary practice location

1 Shircliff Way
Jacksonville, FL 32204-4748

Mailing address

543 Kendall Crossing Dr
St Johns, FL 32259-8766
Phone (904) 521-9796

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
I20230414001733 FL Practitioner - Nurse Practitioner 6507231099 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Florida Jacksonville Physicians, Inc. 908 clinicians

Practice addresses (Care Compare)

653 W 8TH St
Jacksonville, FL 32209-6511

655 W 8TH St
Jacksonville, FL 32209-6511

655 W 8TH St
Jacksonville, FL 32231-6511
Phone (904) 244-6340

76011 William Burgess Rd
Yulee, FL 32097-5428
Phone (904) 427-8590

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medical Specialists of Jacksonville CurrentSince Feb 15, 2023 Accepting new patients
Cep America LLC CurrentSince Jun 21, 2023 Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Jan 20, 2026 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jan 20, 2026 Accepting new patients
Cep America, LLC Current Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Jan 20, 2026 Accepting new patients
Cep America LLC CurrentSince Jun 21, 2023 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

4201 Belfort Rd
Jacksonville, FL 32216
Phone (904) 268-5561

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1675900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1891492831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "543 KENDALL CROSSING DR",
            "city": "ST JOHNS",
            "state": "FL",
            "postal_code": "322598766",
            "telephone_number": "904-521-9796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SHIRCLIFF WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044748",
            "telephone_number": "904-308-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "BENJAMIN",
        "middle_name": "SETH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-09",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11024408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.