MS. KIMBERLY LYNN CANNON FNP-BC
NPI 1407375207
Nurse Practitioner - Family in Livonia, MI

Q: What is Kimberly Cannon's NPI number?

The NPI number for Kimberly Cannon is 1407375207. It was assigned to this individual provider in the NPPES registry on September 12, 2017.

Q: What is Kimberly Cannon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Kimberly Cannon was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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 September 12, 2017PECOS Enrolled

30999 MORLOCK ST # 924, LIVONIA, MI 48152(313) 713-4543(313) 713-4543 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 17, 2018, Sep 12, 2017 (2 updates tracked since 2017).

On this page

About Ms. Kimberly Lynn Cannon Fnp-bc NPPES

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

MS. KIMBERLY LYNN CANNON FNP-BC (NPI 1407375207) is an individual family provider in Livonia, Michigan, licensed in Michigan (4704304007) and active in the NPI registry since September 2017. She is enrolled in Medicare PECOS, maintains a secondary practice location in Livonia, and is a graduate of Other (2009).

NPPES Registry Identity

NPI1407375207

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMS. KIMBERLY LYNN CANNONCredential: FNP-BC

Location Address30999 MORLOCK ST # 924Livonia, MI 48152-1662

Mailing Address5039 Page AveJackson, MI 49201-9101 · (313) 713-4543

Phone(313) 713-4543

Fax(313) 713-4543

Sole ProprietorYes

Medical School CMSOtherGraduated 2009

Enumeration DateSeptember 12, 2017

Last NPPES UpdateMarch 17, 20182 updates tracked since enumeration

✔ NPI 1407375207 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in MI · 4704304007

30999 MORLOCK ST # 924, Livonia, MI 48152

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Secondary Practice Location 1

Location 130999 Morlock St # 924Livonia, MI 48152-1662 · Phone (313) 713-4543 · Fax (313) 713-4543

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include McLaren Health Plan Community.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Kimberly Lynn Cannon Fnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8325585201

PECOS Enrollment IDI20251110000888

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48152 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

$90.76 typical visit price

range $58.04 – $177.36

Typical copayment $22.69 (range $14.51 – $44.34)

Most-billed visit code 99203

Established Patient

$102.35 typical visit price

range $18.32 – $143.49

Typical copayment $25.58 (range $4.58 – $35.87)

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 Kimberly Cannon's NPI number?

The NPI number for Kimberly Cannon is 1407375207. It was assigned to this individual provider in the NPPES registry on September 12, 2017.

Where is Kimberly Cannon located?

Kimberly Cannon practices at 30999 Morlock St # 924, Livonia, MI 48152. The listed phone number is (313) 713-4543.

What is Kimberly Cannon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Kimberly Cannon enrolled in Medicare?

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

What insurance does Kimberly Cannon accept?

Health plans from McLaren Health Plan Community list Kimberly 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 Kimberly Cannon was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.