MICHAEL CANNON, MD PERSONALIZED MEDICINE, LLC
NPI 1326769175
Family Medicine - Sports Medicine in Chesterfield, MO

Q: What is Michael Cannon, MD Personalized Medicine, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Active since September 09, 2022

16216 BAXTER RD STE 340, CHESTERFIELD, MO 63017(314) 325-8925 Get Directions Write a Review

NPPES record last updated: September 9, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Michael Cannon, Md Personalized Medicine, Llc NPPES

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

MICHAEL CANNON, MD PERSONALIZED MEDICINE, LLC (NPI 1326769175) is a healthcare organization registered as a sports medicine in Chesterfield, Missouri and active in the NPI registry since September 2022. The organization lists Michael Cannon, Owner/ Md, as its authorized official.

NPPES Registry Identity

NPI1326769175

Entity TypeOrganization

Primary Taxonomy207QS0010X

Legal Business NameMICHAEL CANNON, MD PERSONALIZED MEDICINE, LLC

Location Address16216 BAXTER RD STE 340Chesterfield, MO 63017-4778

Mailing AddressPo Box 221240Kirkwood, MO 63122-8240

Phone(314) 325-8925

Organization SubpartNo

Authorized OfficialMichael CannonOwner/ Md · (314) 574-2851

Enumeration DateSeptember 9, 2022

NPPES CertifiedSeptember 9, 2022

✔ NPI 1326769175 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QS0010X

Definition

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

16216 BAXTER RD STE 340, Chesterfield, MO 63017

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Michael Cannon, Md Personalized Medicine, 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 Michael Cannon, MD Personalized Medicine, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Michael Cannon, MD

Family Practice

NPI 1154348761

16216 BAXTER RD STE 340
Chesterfield, MO 63017

(314) 325-8925

✔ 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 Michael Cannon, MD Personalized Medicine, LLC's NPI number?

The NPI number for Michael Cannon, MD Personalized Medicine, LLC is 1326769175. It was assigned to this organization in the NPPES registry on September 9, 2022.

Where is Michael Cannon, MD Personalized Medicine, LLC located?

Michael Cannon, MD Personalized Medicine, LLC is located at 16216 Baxter Rd Ste 340, Chesterfield, MO 63017. The listed phone number is (314) 325-8925.

What is Michael Cannon, MD Personalized Medicine, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Is Michael Cannon, MD Personalized Medicine, LLC enrolled in Medicare?

Yes. Michael Cannon, MD Personalized Medicine, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Michael Cannon, MD Personalized Medicine, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Michael Cannon, MD Personalized Medicine, 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.

When was this NPI record last updated?

The NPPES record for Michael Cannon, MD Personalized Medicine, LLC was last updated on September 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.