ADDY ANTLEY CANNON


Address: 126 Dillon Drive, Spartanburg, SC 29307-1018
Phone: 8643271212

ADDY ANTLEY CANNON (NPI# 1386954097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1386954097
Entity Type Individual
Full Name ADDY ANTLEY CANNON
Other Name ADDY ANTLEY SMOKE
Credential PA-C
Practice Address 126 Dillon Drive
Spartanburg
SC 29307-1018
Practice Telephone 8643271212
Practice Fax Number 8643271211
Mailing Telephone 8643271212
Mailing Fax Number 8643271211
Enumeration Date 2010-10-15
Last Update Date 2014-02-19
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
TL1562 SC Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 126 DILLON DRIVE
City SPARTANBURG
State SC
Zip Code 29307-1018

Providers in the same location

NPI Name Taxonomy Address Enumeration
1528025137 Foothills Nephrology PC Internal Medicine 126 Dillon Drive, Spartanburg, SC 29307-1018 2006-04-27
1427036144 David Ellsworth Mullins Internal Medicine 126 Dillon Drive, Foothills Nephrology PC, Spartanburg, SC 29307-1018 2006-01-03

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1023677945 Healogics Specialty Physicians of South Carolina, LLC Clinic/Center 1630 Skylyn Drive, Suite 420, Spartanburg, SC 29307 2019-06-13
1194247528 Tawnia Lee Prince Occupational Therapy Assistant 110 Summit Knoll Drive, Spartanburg, SC 29307 2017-07-07
1730633553 Laura K Taylor Chiropractor 1802 Drayton Road, Suite 309, Spartanburg, SC 29307 2016-08-10
1013372390 Erin Lavette Farr Nurse Practitioner 2780 East Main Street, Ltc Health Solutions, Spartanburg, SC 29307 2015-12-30
1316312010 Joy Rogers Speech-Language Pathologist 175 Burdette St, Spartanburg, SC 29307 2015-12-07
1376923169 Olivia Conrad Speech-Language Pathologist 220 Sloans Grove Rd, Spartanburg, SC 29307 2015-06-05
1457755118 Optimal Radiology Partners of Virginia, Pllc Radiology 75 Skylyn Drive, Spartanburg, SC 29307 2014-10-09
1295033272 Sean Quinn Pharmacist 790 East Main Street, Spartanburg, SC 29307 2011-03-01
1417250887 James Edward Bradof Internal Medicine 212 Cypress Creek Drive, Spartanburg, SC 29307 2010-12-07
1528388030 Tanya Tocharoen Tang Internal Medicine 126 Dillon Dr., Spartanburg, SC 29307 2010-06-07
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1790329324 Alex Holsonback Physician Assistant 101 E Wood St, Spartanburg, SC 29303-3040 2019-11-06
1477905354 Joshua Goedel Physician Assistant 101 E Wood St, Spartanburg, SC 29303-3040 2016-07-05
1356653968 Kristen Bieri Koch Physician Assistant 126 Dillon Dr, Spartanburg, SC 29307-1018 2010-07-12
1902088867 Amanda Falls Broome Physician Assistant 958 E Main St, Spartanburg, SC 29302-2148 2007-12-03
1396933461 Kelly Martin Wilson Physician Assistant 1330 Boiling Springs Rd, Suite 1600, Spartanburg, SC 29303-4201 2007-10-13
1003847286 Toni Hicks Bowyer Physician Assistant 98 Willow Ln, Spartanburg, SC 29307-1357 2006-07-05
1780646000 Bonnie Brown West Physician Assistant 101 E Wood St, Spartanburg, SC 29303-3040 2006-04-03

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1639712482 Brianna Julia Starr Physician Assistant 1403 E Greenville St Ste B, Anderson, SC 29621-2285 2019-10-24
1255974655 Kaitlyn T Brown Physician Assistant 808 Farrar Drive, Conway, SC 29526-8747 2019-10-18
1053960914 Chad Waddell Physician Assistant 107 Walnut Ln, North Augusta, SC 29860-8629 2019-09-04
1508429317 Charlotte H. Hanna Physician Assistant 800 E Cheves St Ste 380, Florence, SC 29506-2649 2019-04-17
1407342116 Thrive Essential Wellness, Inc. Physician Assistant 1511 9th Ave Ste A, Conway, SC 29526-4126 2018-07-05
1700392495 Stephanie Meyer Physician Assistant 5 Medical Park Road Palmetto Health, Columbia, SC 29203 2017-12-18
1073022612 Gina Marie Sanitato Physician Assistant 1300 Hospital Dr Ste 300, Mt Pleasant, SC 29464-3217 2017-09-27
1659896264 Morgan N Warthan Physician Assistant Gateway Family Medicine, 406 N Poinsett Hwy, Travelers Rest, SC 29690-1667 2017-08-04
1366994824 Colonial Family Practice, LLC Physician Assistant 3750 Savannah Hwy Ste I, Johns Island, SC 29455-7909 2016-11-01
1457804080 Mcleod Physician Associates II Physician Assistant 945 82nd Pkwy Ste 3, Myrtle Beach, SC 29572-4612 2016-08-01
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Competitor

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City SPARTANBURG
Zip Code 29307

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Dataset Information

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.

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