CANNON MEMORIAL HOSPITAL (NPI# 1629215298) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629215298 |
| Entity Type | Organization |
| Organization Name | CANNON MEMORIAL HOSPITAL |
| Other Organization Name | CANNON ORTHOPEDICS - DIVINA |
| Practice Address |
3722 Clemson Blvd Suite A Anderson SC 29621-1317 |
| Mailing Address |
Po Box 919 Pickens SC 29671-0919 |
| Practice Telephone | 8642317373 |
| Mailing Telephone | 8648978286 |
| Enumeration Date | 2009-01-19 |
| Last Update Date | 2009-01-19 |
| Authorized Official Name | NORMAN RENTZ (CEO) |
| Authorized Official Telephone | 8648784791 |
| Is Organization Subpart | Y |
| Parent Organization Name | CANNON MEMORIAL HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Cannon Orthopedics - Divina | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760685143 | Cannon Memorial Hospital | Family Medicine | 111 W. Roper Rd., Easley, SC 29640 | 2007-06-06 |
| 1457427494 | Cannon Memorial Hospital | Surgery | 123 Wg Acker Dr Ste D, Pickens, SC 29671-2739 | 2006-11-28 |
| 1497744254 | Cannon Memorial Hospital | General Acute Care Hospital | 123 W G Acker Dr, Pickens, SC 29671-2739 | 2005-10-14 |
| 1295267227 | Cannon Memorial Hospital | Otolaryngology | 885 Tiger Blvd Ste A, Clemson, SC 29631-1480 | 2017-03-29 |
| 1902224876 | Cannon Memorial Hospital | Clinic/Center | 105 Liberty Blvd, Liberty, SC 29657-1641 | 2014-03-28 |
| 1861645558 | Cannon Memorial Hospital | Orthopaedic Surgery | 123 Wg Acker Dr, Suite C, Pickens, SC 29671-2739 | 2008-10-28 |
| 1497910772 | Cannon Memorial Hospital | Family Medicine | 865 Pendleton St, Pickens, SC 29671-2578 | 2008-07-25 |
| 1679738199 | Cannon Memorial Hospital | Orthopaedic Surgery | 115 Brushy Creek Rd, Easley, SC 29642-1120 | 2008-07-24 |
| 1700890084 | Cannon Memorial Hospital | Family Medicine | 111 W Roper Rd, Easley, SC 29640-8805 | 2006-07-29 |
| 1861416216 | Cannon Memorial Hospital | Family Medicine | 123 Wg Acker Dr, Suite B, Pickens, SC 29671-2739 | 2006-07-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CANNON MEMORIAL HOSPITAL | 434 Hospital Dr, Linville, NC 28646 |
| Street Address |
3722 CLEMSON BLVD SUITE A |
| City | ANDERSON |
| State | SC |
| Zip Code | 29621-1317 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114574241 | Kathryn L Harwick | Social Worker | 3030 Sc-81, Anderson, SC 29621 | 2019-08-22 |
| 1326517194 | Ashlea Bronwen Bates | Nurse Practitioner | 3424 Clemson Blvd., Anderson, SC 29621 | 2018-11-21 |
| 1770051708 | Bailee Vernon Mccarley | Nurse Practitioner | 800 Fant St, Anderson, SC 29621 | 2018-11-07 |
| 1790278893 | Morgan Cutts | Speech-Language Pathologist | 126 Broadbent Way, Suite A, Anderson, SC 29621 | 2018-06-13 |
| 1427546233 | Amanda Coker Burnette | Family Medicine | 3000 East Greenville Street, Suite 3700, Anderson, SC 29621 | 2018-04-26 |
| 1205342169 | Robert Allen Dameron Jr. | Orthopaedic Surgery | 130 Longview Drive, Anderson, SC 29621 | 2017-12-14 |
| 1578085411 | Michael Jason Bell | Contractor | 520 Hwy 29 Bypass N, Anderson, SC 29621 | 2017-07-12 |
| 1639629983 | Todd E. Hamilton | Dentist | 1112 Cornelia Road, Anderson, SC 29621 | 2016-10-11 |
| 1760939110 | Crystal Vaughn | Nurse Practitioner | Sac Anmed Health 2000 East Greenville Street, Anderson, SC 29621 | 2016-09-01 |
| 1992151328 | Veronica Williams | Non-emergency Medical Transport (VAN) | 2314 Old Williamston Road, Anderson, SC 29621 | 2016-05-04 |
| Find all providers in zip 29621 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205342169 | Robert Allen Dameron Jr. | Orthopaedic Surgery | 130 Longview Drive, Anderson, SC 29621 | 2017-12-14 |
| 1497989164 | Jay Naresh Shah | Orthopaedic Surgery | 100 Healthy Way Ste 1200, Anderson, SC 29621-7916 | 2009-05-11 |
| 1508083882 | Larry Dennis Ratliff | Orthopaedic Surgery | 446 Cathey Rd, Anderson, SC 29621-3614 | 2007-04-19 |
| 1063405371 | Brett Thomas Krepps | Orthopaedic Surgery | 3125 S Scatterfield Rd Ste 210, Anderson, IN 46013-1802 | 2005-08-23 |
| 1285052753 | Hunter Hsu | Orthopaedic Surgery | 100 Healthy Way Ste 1200, Anderson, SC 29621-7916 | 2014-04-02 |
| 1750647608 | Kyle Stephenson | Orthopaedic Surgery | 3125 S Scatterfield Rd Ste 210, Anderson, IN 46013 | 2012-04-04 |
| 1003111063 | Brian E Camilleri | Orthopaedic Surgery | 2610 Enterprise Dr, Anderson, IN 46013-9684 | 2011-01-21 |
| 1871808188 | Anmed Health | Orthopaedic Surgery | 2000 E Greenville St, Suite 3950, Anderson, SC 29621-1580 | 2010-08-11 |
| 1609004761 | John Charles Saunders IIi | Orthopaedic Surgery | 2000 E Greenville St, Suite 3950, Anderson, SC 29621-1580 | 2009-06-29 |
| 1740464221 | Anmed Health | Orthopaedic Surgery | 112 Montgomery Dr, Anderson, SC 29621-3334 | 2007-12-20 |
| Find all providers in ANDERSON | ||||
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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.