DR. HEATHER CANNON (NPI# 1801082409) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801082409 |
| Entity Type | Individual |
| Full Name | DR. HEATHER CANNON |
| Credential | M.D. |
| Practice Address |
1122 E Main St Suite 4 Philadelphia MS 39350-2348 |
| Practice Telephone | 6016561001 |
| Practice Fax Number | 6016567555 |
| Mailing Telephone | 6016561001 |
| Mailing Fax Number | 6016567555 |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2015-07-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 22698 | MS | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 29398 | AL | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 03123057 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619311982 | Heather Beba Cannon | Registered Nurse | 207 N Beech St, Massapequa, NY 11758-2502 | 2013-04-17 |
| 1902022163 | Heather Michelle Cannon | Social Worker | 96 Ridgedale Ave, Madison, NJ 07940-1251 | 2007-04-17 |
| 1235643784 | Heather Anne Cannon | Counselor | 545 N Magnolia Ave, El Cajon, CA 92020-3608 | 2017-11-20 |
| Street Address |
1122 E MAIN ST SUITE 4 |
| City | PHILADELPHIA |
| State | MS |
| Zip Code | 39350-2348 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639157829 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 1122 E Main St, Philadelphia, MS 39350-2329 | 2006-01-06 |
| 1790173599 | Rachel Richardson | Nurse Practitioner | 1122 E Main St, Suite 4, Philadelphia, MS 39350-2348 | 2014-12-31 |
| 1164727269 | Tonia Holley | Nurse Practitioner | 1122 E Main St, Suite 4, Philadelphia, MS 39350-2348 | 2011-01-20 |
| 1275621211 | Neshoba County General Hospital | Clinic/Center | 1122 E Main St, Suite 4, Philadelphia, MS 39350-2348 | 2006-10-11 |
| 1366541872 | Julia E Riley | Pediatrics | 1122 E Main St, Neshoba Pediatrics Suite 6, Philadelphia, MS 39350-2348 | 2006-09-21 |
| 1871522797 | Hilton M Fairchild | Family Medicine | 1122 E Main St, Suite 4, Philadelphia, MS 39350-2348 | 2006-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548817133 | Airpark Family Dentistry | Dentist | 1060 Holland Avenue, Philadelphia, MS 39350 | 2019-08-20 |
| 1396303962 | Medical Foundation Inc | Obstetrics & Gynecology | Rush Medical Group / Philadelphia, 1106 Central Drive, Ste 3, Philadelphia, MS 39350 | 2019-05-30 |
| 1144759580 | Mapp Home Care Services | In Home Supportive Care | 41 Eastover Dr, Philadelphia, MS 39350 | 2017-06-08 |
| 1710411707 | Rcg Mississippi, Inc. | Clinic/Center | 1100 Central Drive, Philadelphia, MS 39350 | 2017-04-17 |
| 1114339405 | Bernard Oneal | Adult Companion | 10090 Rd 0022, None, Philadelphia, MS 39350 | 2014-05-21 |
| 1417213323 | Region Ten Commision On Mental Health | Clinic/Center | 1011 Posey Avenue, Philadelphia, MS 39350 | 2012-04-04 |
| 1851427132 | Performance Therapy LLC | Physical Therapist | Performance Therapy, LLC, 921 W Beacon Street, Philadelphia, MS 39350 | 2007-02-23 |
| 1922161900 | Ernest Barton Cross | Audiologist | 1120 East Main Street, Suite 4, Philadelphia, MS 39350 | 2006-12-19 |
| 1649348129 | Augustus P Soriano | Family Medicine | 517 Center Avenue, Philadelphia, MS 39350 | 2006-12-01 |
| 1982777983 | Bill G Molpus | Dentist | 247 Byrd Ave, Philadelphia, MS 39350 | 2006-11-16 |
| Find all providers in zip 39350 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
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|---|---|---|---|---|
| 1619587227 | Cmp Medical LLC | Family Medicine | 3626 Sears St, Philadelphia, PA 19146-3217 | 2020-08-07 |
| 1225648140 | Action Health Centers Inc | Family Medicine | 1006 W Lehigh Ave Ste 200, Philadelphia, PA 19133-1640 | 2020-08-05 |
| 1285289876 | Visiting Doctors Inc | Family Medicine | 2338 S Broad St Ste 1, Philadelphia, PA 19145-4450 | 2019-08-09 |
| 1770137218 | Health Care At Northeast Philadelphia LLC | Family Medicine | 3353 Cottman Avenue, Philadelphia, PA 19149-1603 | 2019-08-01 |
| 1679131585 | Aria Health Physician Services | Family Medicine | 3998 Red Lion Rd Ste 204, Philadelphia, PA 19114-1440 | 2019-06-05 |
| 1689232597 | Aria Health Physician Services | Family Medicine | 5000 Frankford Ave Ste 1, Philadelphia, PA 19124-2620 | 2019-06-05 |
| 1174096432 | Temple University of The Commonwealth System of Higher Education | Family Medicine | 2300 W Master St Ste 109b, Philadelphia, PA 19121-4739 | 2019-01-09 |
| 1679043152 | Prevention Point Philadelphia | Family Medicine | 2913-15 Kensington Ave, Philadelphia, PA 19134-3016 | 2018-11-28 |
| 1700362266 | Wes Corporation | Family Medicine | 5000 N 13th St, Philadelphia, PA 19141-3533 | 2018-07-17 |
| 1376046508 | Philly Medical and Rehab Associates | Family Medicine | 6401 Rising Sun Ave, Philadelphia, PA 19111-5228 | 2018-03-14 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 39350 |
Please comment or provide details below to improve the information on DR. HEATHER CANNON.
| 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.