DR. BRETT H CANNON (NPI# 1124132386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124132386 |
| Entity Type | Individual |
| Full Name | DR. BRETT H CANNON |
| Credential | MD |
| Practice Address |
8954 Hospital Dr Douglasville GA 30134-2272 |
| Mailing Address |
5665 New Northside Dr Nw Suite 320 Atlanta GA 30328-5831 |
| Practice Telephone | 7709206420 |
| Mailing Telephone | 7708745400 |
| Mailing Fax Number | 7708745469 |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2007-12-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | MD.25283 | AL | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | 15230R | LA | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | 200301097 | NC | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | 0101236067 | VA | Allopathic & Osteopathic Physicians |
| Y | 207P00000X | Emergency Medicine | 046053 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00866115J | 05 | |
| AL | 051559698 | 05 | |
| AL | AETNA | 7559160 | 01 |
| AL | BCBS | 051542477 | 01 |
| GA | 00866115I | 05 | |
| GA | 00866115K | 05 | |
| GA | 00866115L | 05 |
| Street Address |
8954 HOSPITAL DR |
| City | DOUGLASVILLE |
| State | GA |
| Zip Code | 30134-2272 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730174905 | Eleanor Glaspy-benton | Obstetrics & Gynecology | 8954 Hospital Dr, Suite 120-a, Douglasville, GA 30134-2272 | 2005-09-14 |
| 1194361899 | Danna Michel | Nurse Practitioner | 8954 Hospital Dr, Douglasville, GA 30134-2272 | 2019-11-18 |
| 1144865544 | Wanda Yvonne Wilson-hightower | Nurse Practitioner | 8954 Hospital Dr, Douglasville, GA 30134-2272 | 2019-11-10 |
| 1376184630 | Kyle Robert Schneider | Physician Assistant | 8954 Hospital Dr, Douglasville, GA 30134-2272 | 2019-10-07 |
| 1174187967 | Elizabeth Pressler Aaron | Physician Assistant | 8954 Hospital Dr, Douglasville, GA 30134-2272 | 2019-04-26 |
| 1245744176 | Michael D Mccray | Nurse Anesthetist, Certified Registered | 8954 Hospital Dr, Douglasville, GA 30134 | 2017-11-30 |
| 1891205373 | Mackenzie Lurene Mashburn Grillo | Nurse Practitioner | 8954 Hospital Dr, Douglasville, GA 30134-2272 | 2017-10-10 |
| 1194248385 | Steven Derek Harris | Anesthesiology | 8954 Hospital Dr, Douglasville, GA 30134-2272 | 2017-07-19 |
| 1306367164 | Advent Anesthesia Partners, LLC | Anesthesiology | 8954 Hospital Dr, Anesthesia Dept, Douglasville, GA 30134-2272 | 2017-07-03 |
| 1578917993 | Naga Ratnakar Davuluri | Anesthesiology | 8954 Hospital Dr, Douglasville, GA 30134-2272 | 2016-04-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851915631 | Lilian Pereira | Nurse Practitioner | Bethesda Medical Group, LLC, 9280 Hwy 5 - Suite D, Douglasville, GA 30134 | 2020-06-08 |
| 1548822901 | Sweet Resolve LLC | Nurse Practitioner | 4318 Ridge Rd, Ste 111 Pmb 1017, Douglasville, GA 30134 | 2019-07-05 |
| 1598328791 | Straight Street Life Center Inc | Case Manager/Care Coordinator | 12461 Veterans Memorial, Douglasville, GA 30134 | 2019-04-15 |
| 1174014930 | Caitlin Waldrip | Chiropractor | 8326a Office Park Dr., Douglasville, GA 30134 | 2018-05-28 |
| 1861901050 | Michelle Denise Winston | Licensed Practical Nurse | 6497 E Strickland, Douglasville, GA 30134 | 2017-09-20 |
| 1518335843 | Willis Anthony Rogers | Durable Medical Equipment & Medical Supplies | 7094 Rose Lake Circle, Douglasville, GA 30134 | 2015-09-03 |
| 1497135131 | Patricia Warren | Social Worker | 8317 Office Park Drive Ste.#e, Douglasville, GA 30134 | 2015-06-08 |
| 1457747321 | Kidz Rock Therapy Services, LLC | Occupational Therapist | 6732 West Spring Street, Douglasville, GA 30134 | 2015-04-08 |
| 1386068476 | Naa Y Oden | Psychologist | 4813 Ridge Rd Ste 111-639, Douglasville, GA 30134 | 2014-02-10 |
| 1467893271 | American Ems | Ambulance | 7240 Bankhead Hwy, Douglasville, GA 30134 | 2013-07-09 |
| Find all providers in zip 30134 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639113848 | Mohamad Ali Hamki | Emergency Medicine | 9280 Highway 5 Ste E, Douglasville, GA 30134-1501 | 2006-06-16 |
| 1386943793 | Trevor Craig Smith | Emergency Medicine | 8954 Hospital Dr, Douglasville, GA 30134-2272 | 2011-03-24 |
| 1326149063 | Robert Jordan | Emergency Medicine | 8954 Hospital Dr, Douglasville, GA 30134 | 2006-09-26 |
| 1306959838 | Marc Greg Amaya | Emergency Medicine | 8954 Hospital Dr, Douglasville, GA 30134-2272 | 2006-08-17 |
| 1538190012 | Mark E. Thomas | Emergency Medicine | 9390 The Landing Dr, Douglasville, GA 30135-7120 | 2006-07-05 |
| 1588691612 | Wayne Williams | Emergency Medicine | 9390 The Landing Dr, Douglasville, GA 30135-7180 | 2006-06-26 |
| 1871536771 | Setu S Mazumdar | Emergency Medicine | 8954 Hospital Dr, Douglasville, GA 30134-2272 | 2006-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760081657 | Rtw Health Services LLC | Emergency Medicine | 1951 Lenox Rd Ne, Atlanta, GA 30306-3059 | 2020-10-21 |
| 1790396984 | Chisholm Trail Urgent Care Pllc | Emergency Medicine | 11 Tsys Way, Columbus, GA 31901 | 2020-08-12 |
| 1275141467 | Viral Solutions LLC | Emergency Medicine | 1752 Moonstone Ct, Decatur, GA 30033-1411 | 2020-07-14 |
| 1376102830 | John Edward Cooke | Emergency Medicine | 2411 Tuxedo Ln Nw, Marietta, GA 30064-1898 | 2019-06-10 |
| 1538646526 | Edwige Goby Konwo-tayo | Emergency Medicine | 1183 S Hairston Rd Ste A, Stone Mountain, GA 30088-2796 | 2018-07-23 |
| 1548763899 | South Georgia Er Services, LLC | Emergency Medicine | 313 Carrick Way, Macon, GA 31210-4952 | 2018-03-13 |
| 1922517945 | Infinity Wellness Solutions LLC | Emergency Medicine | 3240 Pointe Parkway, Suite 100, Norcross, GA 30092 | 2017-09-21 |
| 1528594314 | Kendra Chantelle Krieg | Emergency Medicine | 185 Anniversary Ln, Acworth, GA 30102 | 2017-05-11 |
| 1114450806 | Peyton Jones Syed | Emergency Medicine | 13765 Brittle Rd, Alpharetta, GA 30004-3592 | 2017-04-10 |
| 1437690658 | Miles Anthony Medina | Emergency Medicine | 1133 Eagles Landing Pkwy # Er, Stockbridge, GA 30281-5085 | 2017-03-20 |
| Find all providers with the same taxonomy | ||||
| City | DOUGLASVILLE |
| Zip Code | 30134 |
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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.