Individual provider Active NPI

Sheila Nannette Cannon, PMHNP/PMHCNS-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • New Castle, DE
National Provider Identifier
1003859158
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
L8-0010452 Issued in DE
Practice address
100 W Commons Blvd
New Castle, DE 19720-2419
Phone
(302) 224-1400
NPI assigned
Jun 14, 2006
Last updated
Sep 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5007307 NC
Psychiatric/Mental Health Nurse Practitioner 363LP0808X L8-0010452 DE Primary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X LE-0010201 DE
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X 319 NC
Registered Nurse 163W00000X 2512129 NC
Registered Nurse 163W00000X L1-0072437 DE
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 271878 MA

Addresses

Primary practice location

100 W Commons Blvd
New Castle, DE 19720-2419

Mailing address

100 Gardengate Rd
Camden, DE 19934-9648
Phone (757) 478-4372

Other names 1

  • Dr. Sheila Cannon Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170728000005 NC Practitioner - Nurse Practitioner 3375619620 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
L1-0072437DEMDRegistered Nurse
2512129NCMDRegistered Nurse
271878MAMDAdult Psychiatric/Mental Health Registered Nurse
319NCMDAcupuncturist
L8-0010452DEMDPsychiatric/Mental Health Nurse Practitioner
5007307NCMDPsychiatric/Mental Health Nurse Practitioner
LE-0010201DEMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Southeastern United Care LLC CurrentSince May 22, 2017 Accepting new patients

Locations

10 Referendum Dr NE
#F115
Bolivia, NC 28422
Phone (910) 253-5801

3640 Express Dr
Shallotte, NC 28470
Phone (910) 294-8471

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1003859158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GARDENGATE RD",
            "city": "CAMDEN",
            "state": "DE",
            "postal_code": "199349648",
            "telephone_number": "757-478-4372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W COMMONS BLVD",
            "city": "NEW CASTLE",
            "state": "DE",
            "postal_code": "197202419",
            "telephone_number": "302-224-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "SHEILA",
        "middle_name": "NANNETTE",
        "name_prefix": "Dr.",
        "credential": "PMHNP/PMHCNS-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5007307",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DE",
            "license": "L8-0010452",
            "primary": true
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "DE",
            "license": "LE-0010201",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "NC",
            "license": "319",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "2512129",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DE",
            "license": "L1-0072437",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "MA",
            "license": "271878",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHEILA",
            "last_name": "CANNON",
            "prefix": "DR.",
            "credential": "PMHNP, BC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New Castle, DE

Sources for this page

Verify at the official NPI Registry.