ERICIA LATRICE CANNON NURSE PRACTITONER
NPI 1013473891
Nurse Practitioner - Family in Jackson, MS

Q: What is Ericia Cannon's NPI number?

The NPI number for Ericia Cannon is 1013473891. It was assigned to this individual provider in the NPPES registry on February 16, 2019.

Q: What is Ericia Cannon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Ericia Cannon was last updated on March 7, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 16, 2019PECOS Enrolled

3502 W NORTHSIDE DR, JACKSON, MS 39213(601) 362-5321 Get Directions Write a Review

NPPES record last updated: March 7, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 7, 2019, Feb 16, 2019 (2 updates tracked since 2019).

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About Ericia Latrice Cannon Nurse Practitoner NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ERICIA LATRICE CANNON NURSE PRACTITONER (NPI 1013473891) is an individual family provider in Jackson, Mississippi, licensed in Mississippi (903107) and active in the NPI registry since February 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1013473891

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameERICIA LATRICE CANNONCredential: NURSE PRACTITONER

Location Address3502 W NORTHSIDE DRJackson, MS 39213-4454

Mailing Address3502 W Northside DrJackson, MS 39213-4454 · (601) 362-5321

Phone(601) 362-5321

Sole ProprietorNo

Enumeration DateFebruary 16, 2019

Last NPPES UpdateMarch 7, 20192 updates tracked since enumeration

✔ NPI 1013473891 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in MS · 903107

3502 W NORTHSIDE DR, Jackson, MS 39213

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ericia Latrice Cannon Nurse Practitoner is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39213 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$80.50 typical visit price

range $51.65 – $159.18

Typical copayment $20.12 (range $12.91 – $39.79)

Most-billed visit code 99203

Established Patient

$92.20 typical visit price

range $16.15 – $129.61

Typical copayment $23.05 (range $4.03 – $32.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. TIFFANI RICCHELE MCKNIGHT

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