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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MR. MARK ANDREW CANNON PA-C
NPI 1215991484
Physician Assistant - Surgical in Hampton, VA

Active since April 14, 2006PECOS Enrolled
100 EMANCIPATION DR, DEPARTMENT OF SURGERY, HAMPTON, VA 23667(757) 722-9961(757) 728-7052 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Mark Andrew Cannon Pa-c NPPES

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

MR. MARK ANDREW CANNON PA-C (NPI 1215991484) is an individual surgical provider in Hampton, Virginia, licensed in Florida (PA9101892) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1215991484
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameMR. MARK ANDREW CANNONCredential: PA-C
Location Address100 EMANCIPATION DR, DEPARTMENT OF SURGERYHampton, VA 23667-0001
Mailing Address100 Emancipation Dr, Department Of SurgeryHampton, VA 23667-0001 · (757) 722-9961 · Fax (757) 728-7052
Phone(757) 722-9961
Fax(757) 728-7052
Sole ProprietorNo
Enumeration DateApril 14, 2006
Last NPPES UpdateJuly 13, 2026
✔ NPI 1215991484 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in FL · PA9101892
100 EMANCIPATION DR, Hampton, VA 23667
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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)

Mr. Mark Andrew Cannon Pa-c 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.

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. ROSEMARIE TOWNSEND RN
Registered Nurse
100 EMANCIPATION DR
HAMPTON, VA 23667
Hampton City (757) 722-9961
REBECCA MYERS
Social Worker (Clinical)
100 EMANCIPATION DR
HAMPTON, VA 23667
Hampton City (757) 722-4034
NYEEMA DUHART
Pharmacy Technician
100 EMANCIPATION DR
HAMPTON, VA 23667
Hampton City (720) 416-0236
DR. SRIDHAR MADHUNAPANTULA MD
Internal Medicine
100 EMANCIPATION DR
HAMPTON, VA 23667
Hampton City (757) 722-9961
MR. ANTHONY LYNN JONES RKT, CRC
Kinesiotherapist
100 EMANCIPATION DR
HAMPTON, VA 23667
Hampton City (757) 722-9961
MRS. TASHIKO LYNN BRADSHAW BROADHEAD LMSW
Social Worker
100 EMANCIPATION DR
HAMPTON, VA 23667
Hampton City (757) 722-9961
MISS TINA MARIA CROCCO LMSW
Social Worker (Clinical)
100 EMANCIPATION DR
HAMPTON, VA 23667
Hampton City (757) 922-9961
TRISH TRAN
Family Medicine
100 EMANCIPATION DR
HAMPTON, VA 23667
Hampton City (757) 722-9961

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 Mark Cannon's NPI number?

The NPI number for Mark Cannon is 1215991484. It was assigned to this individual provider in the NPPES registry on April 14, 2006.

Where is Mark Cannon located?

Mark Cannon practices at 100 Emancipation Dr Department Of Surgery, Hampton, VA 23667. The listed phone number is (757) 722-9961.

What is Mark Cannon's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Mark Cannon enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Mark Cannon was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 38 days 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.