DR. HEATHER CANNON


Address: 1122 E Main St, Suite 4, Philadelphia, MS 39350-2348
Phone: 6016561001

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
MS 03123057 05

Other Providers HEATHER CANNON

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

Office Location

Street Address 1122 E MAIN ST
SUITE 4
City PHILADELPHIA
State MS
Zip Code 39350-2348

Providers in the same location

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

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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

Competitor

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City PHILADELPHIA
Zip Code 39350

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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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