DR. JIMMIE DALE CANNON JR. (NPI# 1033182043) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033182043 |
| Entity Type | Individual |
| Full Name | DR. JIMMIE DALE CANNON JR. |
| Credential | MD |
| Practice Address |
220 J.l. White Drive Suite 100 Jasper GA 30143-4894 |
| Mailing Address |
275 Collier Road, Nw Suite 500 Atlanta GA 30309-1711 |
| Practice Telephone | 7062538001 |
| Practice Fax Number | 7062538002 |
| Mailing Telephone | 4046052800 |
| Mailing Fax Number | 4043515983 |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2014-10-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
072875 | GA | Allopathic & Osteopathic Physicians |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
14897 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | PTAN | 060021300 | 01 |
| SC | 148977 | 05 |
| Street Address |
220 J.L. WHITE DRIVE SUITE 100 |
| City | JASPER |
| State | GA |
| Zip Code | 30143-4894 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588616510 | Richard A Ryder | Internal Medicine | 220 J.l. White Drive, Suite 100, Jasper, GA 30143-4894 | 2006-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073111845 | George Mackel, Pmhnp-bc, LLC | Nurse Practitioner | 12034 Big Canoe, 400 Shetland Trace, Jasper, GA 30143 | 2020-10-14 |
| 1598363434 | Amanda J Griggs | Massage Therapist | 54 Wolfscratch Village, Jasper, GA 30143 | 2020-10-13 |
| 1801397724 | Jema Day | Nurse Practitioner | 620 J L White Dr Ste 140, Jasper, GA 30143 | 2018-02-26 |
| 1023467545 | North Georgia Personal Care LLC | Home Health | 501 North Main St., Suite B, Jasper, GA 30143 | 2016-06-06 |
| 1871979641 | Sj & J Spine and Pain Group Holding LLC | Pain Medicine | 91 Sammy Mcghee Blvd, Suite 101, Jasper, GA 30143 | 2015-08-04 |
| 1801294293 | Highland Recovery Center | Community/Behavioral Health | 323 Roland Road, Jasper, GA 30143 | 2014-12-17 |
| 1770905861 | Leslie Rhea Hanagan | Speech-Language Pathologist | 22 Dogwood Lane, Jaser, GA 30143 | 2014-01-09 |
| 1669800660 | Pickens County Chiropractic | Chiropractor | 95 North Main Street, Jasper, GA 30143 | 2013-10-29 |
| 1407139264 | Rocky Mountain Holdings LLC | Ambulance | 70 Airport Business Court, Jasper, GA 30143 | 2011-09-27 |
| 1851681415 | Richard J Vandam | Internal Medicine | 1266 Highway 515, Piedmont Mountainside Hospital, Jasper, GA 30143 | 2011-04-15 |
| Find all providers in zip 30143 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295725299 | Jerry Crook | Internal Medicine | 440 Scott Rolen Dr, Jasper, IN 47546-2700 | 2005-10-21 |
| 1407120058 | Michael Duren Md Facp A Professional Association | Internal Medicine | 315 W Houston St, Jasper, TX 75951-4013 | 2012-02-29 |
| 1982884631 | Heartland Cardiology Associates LLC | Internal Medicine | 440 Scott Rolen Dr, Jasper, IN 47546-2700 | 2007-11-10 |
| 1154517357 | Adam S Dawkins M D P C | Internal Medicine | 950 Memorial Dr, Jasper, IN 47546-2625 | 2007-09-20 |
| 1649284779 | Phillip R Dawkins Md PC | Internal Medicine | 950 Memorial Dr, Jasper, IN 47546-2625 | 2006-07-27 |
| 1205870524 | Grandview Cardiology, LLC | Internal Medicine | 980 Highway 28, Suite 102, Jasper, TN 37347-3695 | 2006-06-16 |
| 1790729697 | Malvinder S Makhni | Internal Medicine | 980 Highway 28, Suite 101, Jasper, TN 37347-3695 | 2006-06-15 |
| 1588616510 | Richard A Ryder | Internal Medicine | 220 J.l. White Drive, Suite 100, Jasper, GA 30143-4894 | 2006-05-17 |
| 1881657500 | Michael Duren | Internal Medicine | 315 W Houston St, Jasper, TX 75951-4013 | 2006-04-11 |
| 1659341261 | William E Lehmkuhler | Internal Medicine | 440 Scott Rolen Dr, Jasper, IN 47546-2700 | 2006-01-25 |
| Find all providers in JASPER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.