Jennifer Rena Cannon, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

003040 Issued in GA

Practice address

330 Hospital Dr
BLDG C, Ste 200
Macon, GA 31217-3899

Phone

(478) 745-1191

Fax

(478) 752-3869

NPI assigned

May 30, 2006

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 GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: jennifer.cannon@imapc.eclinicaldirectplus.com

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.

• Internal Medicine Associates, P.C.

  • Internal Medicine Physician
  • Macon, GA
  • NPI 1033180625
  Medicare reassignment

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260921600000",
    "number": "1982651246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 HOSPITAL DR",
            "address_2": "BLDG C, STE 200",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173899",
            "telephone_number": "478-745-1191",
            "fax_number": "478-752-3869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 HOSPITAL DR",
            "address_2": "BLDG C, STE 200",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173899",
            "telephone_number": "478-745-1191",
            "fax_number": "478-752-3869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "JENNIFER",
        "middle_name": "RENA",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-30",
        "last_updated": "2009-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "003040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tawnya Campbell, NP
• Gwenda Faye Canady, RN
• Krystal E Canady, F.N.P
• Candler Road Dental, PC (Franklin Dental & Braces)
• Christopher Douglas Canicatti, PT
• Randall Clay Cannon, PT
• Brandon Cantrell, PA
• Cencereitte Canty-Jackson, FNP-C
• Capital Anesthesia Associates, LLC
• Shelby Laray Caprara

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.