Individual provider Active NPI

Tyler Austin Cannon, M.D.

  • Orthopaedic Surgery Physician
  • Memphis, TN
National Provider Identifier
1891967147
Registry record updated Oct 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
51585 Issued in TN
Practice address
1244 Primacy Pkwy
Memphis, TN 38119-0201
Phone
(901) 767-8662
Fax
(901) 767-8666
NPI assigned
Mar 27, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Hand Surgery Physician 207XS0106X 51585 TN
Orthopaedic Surgery Physician 207X00000X 51585 TN Primary

Addresses

Primary practice location

1244 Primacy Pkwy
Memphis, TN 38119-0201

Mailing address

6077 Primacy Pkwy Ste 140
Memphis, TN 38119-5742
Phone (901) 725-8347

Other practice location 1

3045 Kate Bond Rd
Bartlett, TN 38133-4004
Phone (901) 381-4664

Other identifiers 1

IdentifierTypeStateIssuer
51585OtherTNTN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140930002153 TN Practitioner - Hand SurgeryPractitioner - Orthopedic Surgery 7113156357 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hand SurgeryAlso: Orthopedic Surgery
Education
University of Tennessee, HSC, College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MSK Group PCGroup PAC ID 4688574262, 138 clinicians

Practice addresses (Care Compare)

13690 Hwy 51 S
Suite 104
Atoka, TN 38004-7645
Phone (901) 641-3000

6286 Briarcrest Ave
Memphis, TN 38120-4023

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125323CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
MSK Group, PC Orthopaedic Surgery CurrentSince Sep 1, 2014 Accepting new patients
MSK Group, PC Orthopaedic Surgery CurrentSince Sep 1, 2014 Accepting new patients
MSK Group PC Orthopaedic Surgery Past Accepting new patients

Locations

8010 Stage Hills Blvd
Bartlett, TN 38133
Phone (901) 937-3200

3045 Kate Bond Rd
Bartlett, TN 38133
Phone (901) 381-4664

2100 Exeter Rd
Ste 200
Germantown, TN 38138
Phone (901) 522-6440

6286 Briarcrest Ave
Ste 100
Memphis, TN 38120
Phone (901) 259-1600

6286 Briarcrest Ave
#200
Memphis, TN 38120
Phone (901) 259-1600

1244 Primacy Pkwy
Memphis, TN 38119
Phone (901) 767-8662

6077 E Primacy Pkwy
Ste 140
Memphis, TN 38119
Phone (901) 725-8347

Interoperability endpoints

  • Direct secure messaging: tcannon33888@mlh.direct-ci.com
  • Direct secure messaging: tcannon@orthosouth.emadirect.md

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1891967147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6077 PRIMACY PKWY STE 140",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195742",
            "telephone_number": "901-725-8347",
            "fax_number": "901-259-7637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 PRIMACY PKWY",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381190201",
            "telephone_number": "901-767-8662",
            "fax_number": "901-767-8666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3045 Kate Bond Rd",
            "address_purpose": "LOCATION",
            "city": "Bartlett",
            "state": "TN",
            "postal_code": "381334004",
            "country_code": "US",
            "telephone_number": "901-381-4664",
            "fax_number": "901-373-3804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANNON",
        "first_name": "TYLER",
        "middle_name": "AUSTIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-27",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "TN",
            "license": "51585",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": "51585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN LICENSE",
            "identifier": "51585",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.