Amanda Cannon, is a medicare enrolled "Clinical Nurse Specialist - Adult Health" in Kenly, North Carolina. Her current practice location is
101 E 2nd St, Kenly, North Carolina. You can reach out to her office (for appointments etc.) via phone at
(919) 284-4025.
Amanda Cannon is licensed to practice in North Carolina (license number 5007198) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1245632157.
Provider's Profile
| Full Name | Amanda Cannon |
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| Gender | Female |
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| Speciality | Clinical Nurse Specialist - Adult Health |
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| Location | 101 E 2nd St, Kenly, North Carolina |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1245632157
- Provider Enumeration Date: 09/23/2014
- Last Update Date: 05/14/2015
Medicare PECOS Information:
- PECOS PAC ID: 0749509149
- Enrollment ID: I20150506002814
Medical Identifiers
Medical identifiers for Amanda Cannon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1245632157 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 364SA2200X | Clinical Nurse Specialist - Adult Health | 5007198 (North Carolina) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Amanda Cannon allows following entities to bill medicare on her behalf.
| Entity Name | Vidant Medical Group Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1477648731
PECOS PAC ID: 0345343893
Enrollment ID: O20070321000445 |
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| Entity Name | Kenly Medical Associates Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1518075712
PECOS PAC ID: 2567657448
Enrollment ID: O20101117001110 |
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| Entity Name | Signify Health Medical Associates Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1750845863
PECOS PAC ID: 2163764424
Enrollment ID: O20191001003503 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amanda Cannon is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Amanda Cannon,
Po Box 275,
Kenly, NC 27542-0275
Ph: (919) 284-4025 | Amanda Cannon,
101 E 2nd St,
Kenly, NC 27542-7794
Ph: (919) 284-4025 |
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