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JACQUELINE FELICIA CANNON APRN, AGPCNP
NPI 1801696380
Nurse Practitioner - Gerontology in Raleigh, NC

Active since March 14, 2025PECOS EnrolledAccepts Medicare Assignment
160 MINE LAKE CT STE 200, RALEIGH, NC 27615(855) 984-5121 Get Directions Write a Review

NPPES record last updated: March 24, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 24, 2025, Mar 14, 2025 (2 updates tracked since 2025).

About Jacqueline Felicia Cannon Aprn, Agpcnp NPPES

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

JACQUELINE FELICIA CANNON APRN, AGPCNP (NPI 1801696380) is an individual gerontology provider in Raleigh, North Carolina, licensed in North Carolina (5021868) and active in the NPI registry since March 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1801696380
Entity TypeIndividualFemale
Primary Taxonomy363LG0600X
Provider Legal NameJACQUELINE FELICIA CANNONCredential: APRN, AGPCNP
Location Address160 MINE LAKE CT STE 200Raleigh, NC 27615-6417
Mailing Address160 Mine Lake Ct Ste 200Raleigh, NC 27615-6417 · (919) 630-3936
Phone(855) 984-5121
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateMarch 14, 2025
Last NPPES UpdateMarch 24, 20252 updates tracked since enumeration
NPPES CertifiedMarch 24, 2025
✔ NPI 1801696380 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
License✔ Licensed in NC · 5021868
160 MINE LAKE CT STE 200, Raleigh, NC 27615
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jacqueline Felicia Cannon Aprn, Agpcnp 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 ID9133600828
PECOS Enrollment IDI20260220001367
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 Reassignments

2

Medicare enrollment records show Jacqueline Cannon reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Goshen Medical Center Incorporated
17 mi
Federally Qualified Health Center (FQHC)
1624 WHITE OAK CHURCH RD
Apex, NC 27523
  • Reassigned Medicare billing, North Carolina enrollment
  • 173 clinicians in this Medicare group
NPI 1558931766 (941) 267-2042
Signify Health Medical Associates, PLLC
1,058 mi
General Practice
4055 VALLEY VIEW LN STE 700
Dallas, TX 75244
  • Reassigned Medicare billing, North Carolina enrollment
  • 728 clinicians in this Medicare group
NPI 1750845863 (972) 715-3800

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 27615 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
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
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.

Other Providers at the Same Location NPPES 13

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

BRANDON GOLD P.A.
Physician Assistant (Surgical)
160 MINE LAKE CT STE 200
RALEIGH, NC 27615
Wake County (305) 466-9988
TLN PROFESSIONAL SERVICES PLLC
Lactation Consultant, Non-RN
160 MINE LAKE CT STE 200
RALEIGH, NC 27615
Wake County (888) 510-0059
PRIME NC HEALTH, LLC
Specialist/Technologist, Other (Electroneurodiagnostic)
160 MINE LAKE CT STE 200
RALEIGH, NC 27615
Wake County (404) 805-4288
DR. BYRON KEITH FORGY M.D.
Surgery
160 MINE LAKE CT STE 200
RALEIGH, NC 27615
Wake County (305) 466-9988
SKY CARE ABA NORTH CAROLINA LLC
Behavior Analyst
160 MINE LAKE CT STE 200
RALEIGH, NC 27615
Wake County (800) 604-2273
AMY CARDENAS MA, NBC-HWC
Health and Wellness Coach
160 MINE LAKE CT STE 200
RALEIGH, NC 27615
Wake County (919) 344-1288
TATHYANA DELVA FNP-BC
Nurse Practitioner (Family)
160 MINE LAKE CT STE 200
RALEIGH, NC 27615
Wake County (704) 497-3426
QUALITY SURGICAL MANAGEMENT PA
Surgery
160 MINE LAKE CT STE 200
RALEIGH, NC 27615
Wake County (305) 466-9988

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 Jacqueline Cannon's NPI number?

The NPI number for Jacqueline Cannon is 1801696380. It was assigned to this individual provider in the NPPES registry on March 14, 2025.

Where is Jacqueline Cannon located?

Jacqueline Cannon practices at 160 Mine Lake Ct Ste 200, Raleigh, NC 27615. The listed phone number is (855) 984-5121.

What is Jacqueline Cannon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Is Jacqueline Cannon enrolled in Medicare?

Yes. Jacqueline 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.

Which organizations bill Medicare for Jacqueline Cannon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacqueline Cannon reassigns Medicare benefits to 2 organizations: Goshen Medical Center Incorporated (Apex, NC) and Signify Health Medical Associates, PLLC (Dallas, TX). Each 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 Jacqueline Cannon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jacqueline Cannon accept?

Health plans from Blue Cross and Blue Shield of NC list Jacqueline 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 Jacqueline Cannon was last updated on March 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.