Victoria Elizabeth Cannon, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5090PA Issued in SC

Practice address

250 Parkbrooke PL Ste 300
Woodstock, GA 30189-6401

Phone

(770) 442-1911

Fax

(770) 928-2601

NPI assigned

Nov 4, 2021

Last updated

Oct 24, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, SC2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Apogee Medical Group South CarolinaGroup PAC ID 8921193020, 69 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Musc Health Columbia Medical Center Downtown Hospital, Columbia, SC, CCN 420026

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: vcannon448001@direct.musc.edu

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.

• Apogee Medical Group South Carolina

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1619028545

  SC

  Medicare reassignment Care Compare group
• Southeast Medical Group, P.C.

  dba North Atlanta Primary Care, P.C.

  • Family Medicine Physician
  • Alpharetta, GA
  • NPI 1235296054
  Medicare reassignment

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

• Medical University Hospital Authority

  dba MUSC Health Columbia Medical Center Northeast

  • General Acute Care Hospital
  • Columbia, SC
  • NPI 1285200105
  Care Compare affiliation
• Medical University Hospital Authority

  dba MUSC Health Columbia Medical Center Downtown

  • General Acute Care Hospital
  • Columbia, SC
  • NPI 1558937474
  Care Compare affiliation
• Medical University Hospital Authority

  • Urgent Care Clinic/Center
  • Columbia, SC
  • NPI 1578402764

  Hospital

  Care Compare affiliation
• Medical University Hospital Authority

  dba MUSC Health Fairfield Emergency and Imaging Center

  • Clinic/Center
  • Winnsboro, SC
  • NPI 1811563737

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1635984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1952066904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 ACORN CT",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296093111",
            "telephone_number": "864-451-2745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 PARKBROOKE PL STE 300",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301896401",
            "telephone_number": "770-442-1911",
            "fax_number": "770-928-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "VICTORIA",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-04",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "5090PA",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle Winters Calhoun, CRNA
• Charles Phillip Callihan Sr., R.PH.
• Camellia Place of Woodstock, LLC
• Jose Miguel Canelon, DPT
• Robert Clayton Cannon, DMD
• Canton Ear Nose and Throat Clinic, P.C.
• Kristen Marie Capovilla, WHNP-BC
• Raymond V Caputo, D.C.
• Claire Carder
• Jason Cardillo, PTA

• Physician Assistant in Woodstock, GA
• Providers in Woodstock, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; 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.