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SPENCER CANNON R.N.
NPI 1346525201
Nurse Practitioner - Pediatrics in Salt Lake City, UT

Active since October 11, 2011PECOS Enrolled
161 S DOOLEY CT, SALT LAKE CITY, UT 84102(801) 696-8513 Get Directions Write a Review

NPPES record last updated: March 4, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 4, 2024, Oct 24, 2023 (2 updates tracked since 2023).

About Spencer Cannon R.n. NPPES

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

SPENCER CANNON R.N. (NPI 1346525201) is an individual pediatrics provider in Salt Lake City, Utah, licensed in Utah (8038048-4405) and active in the NPI registry since October 2011. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1346525201
Entity TypeIndividualMale
Primary Taxonomy363LP0200X
Provider Legal NameSPENCER CANNONCredential: R.N.
Location Address161 S DOOLEY CTSalt Lake City, UT 84102-4104
Mailing Address161 S Dooley CtSalt Lake City, UT 84102-4104 · (801) 696-8513
Phone(801) 696-8513
Sole ProprietorNo
Enumeration DateOctober 11, 2011
Last NPPES UpdateMarch 4, 20242 updates tracked since enumeration
NPPES CertifiedMarch 4, 2024
✔ NPI 1346525201 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in UT · 8038048-4405
Also ListedRegistered NurseTaxonomy 163W00000X · License 8038048-3102 (UT)
Also ListedRegistered Nurse · PediatricsTaxonomy 163WP0200X · License 8038048-3102 (UT)
161 S DOOLEY CT, Salt Lake City, UT 84102
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Imperial Health Plan of the Southwest, Inc., Molina Healthcare and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Spencer Cannon R.n. 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.

Medicare Billing Reassignment

Medicare enrollment records show Spencer Cannon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

University Of Utah Pediatric Services
1.4 mi
Pediatrics
50 N MEDICAL DR
Salt Lake City, UT 84132
  • Reassigned Medicare billing, Utah enrollment
  • 751 clinicians in this Medicare group
NPI 1568826055 (801) 587-6336

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84102 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
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
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 Spencer Cannon's NPI number?

The NPI number for Spencer Cannon is 1346525201. It was assigned to this individual provider in the NPPES registry on October 11, 2011.

Where is Spencer Cannon located?

Spencer Cannon practices at 161 S Dooley Ct, Salt Lake City, UT 84102. The listed phone number is (801) 696-8513.

What is Spencer Cannon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Spencer Cannon enrolled in Medicare?

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

Which organization bills Medicare for Spencer Cannon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Spencer Cannon reassigns Medicare benefits to University Of Utah Pediatric Services (Salt Lake City, UT). The 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 Spencer Cannon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Spencer Cannon accept?

Health plans from BridgeSpan Health Company, Imperial Health Plan of the Southwest, Inc., Molina Healthcare, Regence BlueCross BlueShield of Utah and University of Utah Health Plans list Spencer Cannon 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 Spencer Cannon was last updated on March 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.