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RUBABA CANNON
NPI 1073964458
Nurse Practitioner - Psychiatric/Mental Health in Atlanta, GA

Active since June 27, 2016PECOS Enrolled
3621 VININGS SLOPE SE UNIT 1332, ATLANTA, GA 30339(404) 307-9691 Get Directions Write a Review

NPPES record last updated: January 29, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Rubaba Cannon NPPES

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

RUBABA CANNON (NPI 1073964458) is an individual psychiatric/mental health provider in Atlanta, Georgia, licensed in Georgia (RN242262) and active in the NPI registry since June 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1073964458
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameRUBABA CANNON
Location Address3621 VININGS SLOPE SE UNIT 1332Atlanta, GA 30339-4168
Mailing Address3621 Vinings Slope Se Unit 1332Atlanta, GA 30339-4168 · (404) 307-9691
Phone(404) 307-9691
Sole ProprietorNo
Enumeration DateJune 27, 2016
Last NPPES UpdateJanuary 29, 2025
NPPES CertifiedJanuary 29, 2025
✔ NPI 1073964458 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in GA · RN242262
3621 VININGS SLOPE SE UNIT 1332, Atlanta, GA 30339
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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)

Rubaba Cannon 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 30339 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
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
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.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Rubaba Cannon's NPI number?

The NPI number for Rubaba Cannon is 1073964458. It was assigned to this individual provider in the NPPES registry on June 27, 2016.

Where is Rubaba Cannon located?

Rubaba Cannon practices at 3621 Vinings Slope SE Unit 1332, Atlanta, GA 30339. The listed phone number is (404) 307-9691.

What is Rubaba Cannon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Rubaba Cannon enrolled in Medicare?

Yes. Rubaba Cannon is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Rubaba Cannon was last updated on January 29, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.