KELLY M CANNON (NP) – Nurse Practitioner, NPI 1992160451
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,106 NURSE PRACTITIONER in MI
Provider Addresses for KELLY M CANNON (NP)
205 N EAST AVE
JACKSON, MI 492011753
Phone: (517) 788-4730
Fax: (517) 788-4701
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2016-09-15
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20160915002190 | I | Nurse Practitioner | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 70 | 25 | $0 |
| 99442 | Telephone medical discussion with physician, 11-20 minutes | 39 | 26 | $0 |
| 99443 | Telephone medical discussion with physician, 21-30 minutes | 33 | 23 | $0 |
| 99441 | Telephone medical discussion with physician, 5-10 minutes | 15 | 13 | $0 |
Insurance plans in this area (ZIP 49201)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| NURSE PRACTITIONER | MI | 90792 | Psychiatric diagnostic evaluation with medical services | 31 | 29 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| P S Y C H I A T R Y | MI |
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