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MS. COURTLYN ASHLIE CANNON PA-C
NPI 1740142611
Physician Assistant in Gainesville, FL

Active since December 01, 2025PECOS Enrolled
1600 SW ARCHER RD, GAINESVILLE, FL 32610(352) 265-5911(352) 265-5606 Get Directions Write a Review

NPPES record last updated: January 14, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 14, 2026, Jan 2, 2026, Dec 1, 2025 (3 updates tracked since 2025).

About Ms. Courtlyn Ashlie Cannon Pa-c NPPES

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

MS. COURTLYN ASHLIE CANNON PA-C (NPI 1740142611) is an individual physician assistant in Gainesville, Florida, licensed in Florida (PA9121043) and active in the NPI registry since December 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1740142611
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMS. COURTLYN ASHLIE CANNONCredential: PA-C
Location Address1600 SW ARCHER RDGainesville, FL 32610-3003
Mailing AddressPo Box 100186Gainesville, FL 32610-0186 · (352) 265-5911 · Fax (352) 265-5606
Phone(352) 265-5911
Fax(352) 265-5606
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateDecember 1, 2025
Last NPPES UpdateJanuary 14, 20263 updates tracked since enumeration
NPPES CertifiedJanuary 14, 2026
✔ NPI 1740142611 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in FL · PA9121043
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1600 SW ARCHER RD, Gainesville, FL 32610
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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. Courtlyn Ashlie Cannon Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID143706044
PECOS Enrollment IDI20260110000015
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 32610 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
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 20

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

DR. BAHAREH EBADIFAR KEITH DO
Pediatrics
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 273-0462
AFRASYAB KHAN
Surgery
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 265-0680
GULSUN ERDAG MD
Pathology (Anatomic Pathology & Clinical Pathology)
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 265-9900
DR. ALBERT H. MATTIA D.D.S.
Dentist (Prosthodontics)
1600 SW ARCHER RD, D4-4
GAINESVILLE, FL 32610
Alachua County (352) 273-5801
JOANNA CHAFFIN
Pathology (Anatomic Pathology & Clinical Pathology)
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 627-9272
DR. CASEY JUSTIN BEAL MD
Ophthalmology
1600 SW ARCHER RD, BOX 100284
GAINESVILLE, FL 32610
Alachua County (352) 273-8778
WILLIAM CRAIG HICKS CRNA
Nurse Anesthetist, Certified Registered
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 273-6438
HENRY FONTILLAS PATALINGHUG CRNA
Nurse Anesthetist, Certified Registered
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 273-6438

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 Courtlyn Cannon's NPI number?

The NPI number for Courtlyn Cannon is 1740142611. It was assigned to this individual provider in the NPPES registry on December 1, 2025.

Where is Courtlyn Cannon located?

Courtlyn Cannon practices at 1600 SW Archer Rd, Gainesville, FL 32610. The listed phone number is (352) 265-5911.

What is Courtlyn Cannon's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Courtlyn Cannon enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Courtlyn Cannon was last updated on January 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.