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PEACHTREE MEDICAL CARE, LLC
NPI 1235721879
Clinic/Center in Sandy, UT

Active since February 04, 2021

NPPES record last updated: March 8, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 8, 2021, Feb 4, 2021 (2 updates tracked since 2021).

About Peachtree Medical Care, Llc NPPES

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

PEACHTREE MEDICAL CARE, LLC (NPI 1235721879) is a healthcare organization registered as a clinic/center in Sandy, Utah and active in the NPI registry since February 2021. The organization lists Lorena Cannon, Owner / Provider, as its authorized official.

NPPES Registry Identity

NPI1235721879
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameLORENA CANNON LLC
Location Address893 E 9400 SSandy, UT 84094-3671
Mailing Address893 E 9400 SSandy, UT 84094-3671 · (385) 335-7862
Phone(385) 335-7862
Organization SubpartNo
Authorized OfficialLorena CannonOwner / Provider · (208) 351-5458
Enumeration DateFebruary 4, 2021
Last NPPES UpdateMarch 8, 20212 updates tracked since enumeration
NPPES CertifiedMarch 8, 2021
✔ NPI 1235721879 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Also ListedNurse PractitionerTaxonomy 363L00000X
893 E 9400 S, Sandy, UT 84094
Open in Google Maps ↗

Other Names 2

Doing Business AsPeachtree Medical Care, Llc
Doing Business AsPeachtree Medical Clinic

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare, University of Utah Health Plans.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Peachtree Medical Care, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Peachtree Medical Care, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Lorena Cannon, APRN
Nurse Practitioner
NPI 1255992202
893 E 9400 S
Sandy, UT 84094
(385) 335-7862
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Lorena Cannon LLC's NPI number?

The NPI number for Lorena Cannon LLC is 1235721879. It was assigned to this organization in the NPPES registry on February 4, 2021. The provider is doing business as Peachtree Medical Care, LLC and Peachtree Medical Clinic.

Where is Lorena Cannon LLC located?

Lorena Cannon LLC is located at 893 E 9400 S, Sandy, UT 84094. The listed phone number is (385) 335-7862.

What is Lorena Cannon LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Is Lorena Cannon LLC enrolled in Medicare?

Yes. Lorena Cannon LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lorena Cannon LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Lorena Cannon LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Lorena Cannon LLC accept?

Health plans from Molina Healthcare and University of Utah Health Plans list Lorena Cannon LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lorena Cannon LLC was last updated on March 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.