Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Addy Antley Cannon, PA-C

Individual provider Medical Physician Assistant · NPI 1386954097

Addy Antley Cannon, PA-C is a Physician Assistant in Spartanburg, South Carolina. Qualified in 2010, 16 years ago. Practices with Foothills Nephrology PC, a 7-clinician group and accepts Medicare assignment. Licensed in South Carolina.

Years since qualifying
16
Licensed in
SC
In the registry since
2010
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

126 Dillon Dr
Spartanburg, SC 29307-1018
Phone: (864) 327-1212
Fax: (864) 327-1211
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence TL1562 (SC)

Record details

NPI number1386954097
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 15, 2010
Last updated in NPPESFebruary 19, 2014

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Foothills Nephrology Pc — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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