Robert M Cannon MD LLC
NPI 1174067250 · Primary Care Clinic/Center · Vicksburg, MS
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Robert M Cannon MD LLC is a Primary Care Clinic/Center organization in Vicksburg, MS (NPI 1174067250).
Provider details
- NPI number
- 1174067250
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Robert Cannon, MD(601) 636-0097
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2016-12-08
- Last updated
- 2016-12-08
Frequently asked questions
- What is Robert M Cannon MD LLC's NPI number?
- Robert M Cannon MD LLC's National Provider Identifier (NPI) is 1174067250, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Robert M Cannon MD LLC?
- Robert M Cannon MD LLC is classified in the NPPES registry as Primary Care Clinic/Center (Ambulatory Health Care Facilities).
- Where is Robert M Cannon MD LLC located?
- Robert M Cannon MD LLC's practice location on file with NPPES is 1901 Mission 66, Vicksburg, MS 39180-3711.
- What is Robert M Cannon MD LLC's phone number?
- The practice phone number listed in the NPPES registry for Robert M Cannon MD LLC is (601) 636-0097.
- Does Robert M Cannon MD LLC accept Medicare?
- Robert M Cannon MD LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Robert M Cannon MD LLC?
- The authorized official listed on Robert M Cannon MD LLC's NPPES record is Robert Cannon, MD. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Robert M Cannon MD LLC's NPI active?
- Yes — Robert M Cannon MD LLC's NPI (1174067250) is active in the NPPES registry as of the last update on 2016-12-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.