ADDY ANTLEY CANNON PA-C
NPI 1386954097
Physician Assistant - Medical in Spartanburg, SC

Q: What is Addy Cannon's NPI number?

The NPI number for Addy Cannon is 1386954097. It was assigned to this individual provider in the NPPES registry on October 15, 2010. The provider is also known as Addy Antley Smoke Pa-C.

Q: What is Addy Cannon's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Addy Cannon was last updated on February 19, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.

Active since October 15, 2010PECOS EnrolledAccepts Medicare Assignment

126 DILLON DRIVE, SPARTANBURG, SC 29307(864) 327-1212(864) 327-1211 Get Directions Write a Review

NPPES record last updated: February 19, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Addy Antley Cannon Pa-c NPPES

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

ADDY ANTLEY CANNON PA-C (NPI 1386954097) is an individual medical provider in Spartanburg, South Carolina, licensed in South Carolina (TL1562) and active in the NPI registry since October 2010. She is enrolled in Medicare PECOS and is a graduate of Other (2010).

NPPES Registry Identity

NPI1386954097

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameADDY ANTLEY CANNONCredential: PA-C

Location Address126 DILLON DRIVESpartanburg, SC 29307-1018

Mailing Address126 Dillon DriveSpartanburg, SC 29307-1018 · (864) 327-1212 · Fax (864) 327-1211

Phone(864) 327-1212

Fax(864) 327-1211

Sole ProprietorNo

Medical School CMSOtherGraduated 2010

Enumeration DateOctober 15, 2010

Last NPPES UpdateFebruary 19, 2014

✔ NPI 1386954097 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in SC · TL1562

126 DILLON DRIVE, Spartanburg, SC 29307

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Other Names 1

Former Name (1)Addy Antley Smoke Pa-c

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, First Choice Next and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Addy Antley Cannon Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9638138498

PECOS Enrollment IDI20111018000079

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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

41 services24 patients

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FOOTHILLS NEPHROLOGY PC

Internal Medicine (Nephrology)

126 DILLON DRIVE
SPARTANBURG, SC 29307

Spartanburg County (864) 327-1212

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 Addy Cannon's NPI number?

The NPI number for Addy Cannon is 1386954097. It was assigned to this individual provider in the NPPES registry on October 15, 2010. The provider is also known as Addy Antley Smoke Pa-C.

Where is Addy Cannon located?

Addy Cannon practices at 126 Dillon Drive, Spartanburg, SC 29307. The listed phone number is (864) 327-1212.

What is Addy Cannon's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Addy Cannon enrolled in Medicare?

Yes. Addy Cannon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Addy Cannon accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, First Choice Next, InStil Health and Molina Healthcare list Addy 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 Addy Cannon was last updated on February 19, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.