DR. OCTAVIA MANETTA CANNON D.O.
NPI 1497734701
Obstetrics & Gynecology in East Lansing, MI

Active since January 13, 2006PECOS EnrolledAccepts Medicare Assignment
1560 TURF LN, EAST LANSING, MI 48823(517) 484-3000 Get Directions Write a Review

NPPES record last updated: September 2, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Octavia Manetta Cannon D.o. NPPES

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

DR. OCTAVIA MANETTA CANNON D.O. (NPI 1497734701) is an individual obstetrics & gynecology provider in East Lansing, Michigan, licensed in Michigan (5101012864) and active in the NPI registry since January 2006. She is enrolled in Medicare PECOS, is affiliated with Edward W Sparrow Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1497734701
Entity TypeIndividualFemale
Primary Taxonomy207V00000X
Provider Legal NameDR. OCTAVIA MANETTA CANNONCredential: D.O.
Location Address1560 TURF LNEast Lansing, MI 48823-6392
Mailing Address1560 Turf LnEast Lansing, MI 48823-6392 · (517) 484-3000 · Fax (517) 484-6358
Sole ProprietorNo
Medical School CMSNova Southeastern College Of Osteo MedicineGraduated 1995
Enumeration DateJanuary 13, 2006
Last NPPES UpdateSeptember 2, 2021
NPPES CertifiedSeptember 2, 2021
NPI 1497734701 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
Licenses Licensed in MI · 5101012864 Licensed in NC · 99-00020
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
Also ListedSpecialistTaxonomy 174400000X · License 9900020 (NC)
1560 TURF LN, East Lansing, MI 48823

Secondary Practice Locations 2

Location 13125 Springbank Ln, SUITE BCharlotte, NC 28226-3345 · Phone (704) 341-1103 ext. 107 · Fax (704) 341-3460
Location 21100 S Cedar StMason, MI 48854-2009 · Phone (517) 484-3000

Other Identifiers 2

Medicaid891197HNC
Other5101012864MI · Michigan Physician License

Accepted 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

Dr. Octavia Manetta Cannon D.o. 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 ID7719901727
PECOS Enrollment IDI20210907000549
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.

Cervical or vaginal cancer screening; pelvic and clinical breast examination G0101
This procedure involves checking for health issues in the lower abdomen and chest area. It helps identify early signs of certain conditions, increasing the chance for successful treatment. It's a routine check-up that's important for maintaining good health.
12 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Edward W Sparrow Hospital

Acute Care Hospitals · Lansing, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number230230
Location1215 E Michigan AvenueLansing, MI 48912 · Ingham County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48823 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
$126.15 typical visit price
range $54.34 – $166.68
Typical copayment $31.53 (range $13.58 – $41.67)
Most-billed visit code 99204
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 14

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

Obstetrics & Gynecology
1560 TURF LN
EAST LANSING, MI 48823
Obstetrics & Gynecology
1560 TURF LN
EAST LANSING, MI 48823
Advanced Practice Midwife
1560 TURF LN
EAST LANSING, MI 48823
Obstetrics & Gynecology
1560 TURF LN
EAST LANSING, MI 48823
Nurse Practitioner (Obstetrics & Gynecology)
1560 TURF LN
EAST LANSING, MI 48823
Obstetrics & Gynecology
1560 TURF LN
EAST LANSING, MI 48823
Obstetrics & Gynecology
1560 TURF LN
EAST LANSING, MI 48823
Nurse Practitioner (Obstetrics & Gynecology)
1560 TURF LN
EAST LANSING, MI 48823

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 Octavia Cannon's NPI number?

The NPI number for Octavia Cannon is 1497734701. It was assigned to this individual provider in the NPPES registry on January 13, 2006.

Where is Octavia Cannon located?

Octavia Cannon practices at 1560 Turf Ln, East Lansing, MI 48823. The listed phone number is (517) 484-3000.

What is Octavia Cannon's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Octavia Cannon enrolled in Medicare?

Yes. Octavia 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 Octavia Cannon accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 3 other insurers list Octavia 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.

Is Octavia Cannon affiliated with any hospitals?

According to CMS data, Octavia Cannon is affiliated with Edward W Sparrow Hospital.

When was this NPI record last updated?

The NPPES record for Octavia Cannon was last updated on September 2, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.