Active NPI
Tandalaya Sarah Cannon-Phillips, SEERS LAMA
- Personal Care Attendant
- Philadelphia, PA
National Provider Identifier
1013166198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- License
- CNA 9994672
- Practice address
- 714 Rhawn St
Apt 12a
Philadelphia, PA 19111-2513 - Phone
- (215) 725-0648
- Fax
- (267) 467-0046
- NPI assigned
- Sep 15, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 9
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | |||
| Case Manager/Care Coordinator | 171M00000X | |||
| Pathology Technician | 246R00000X | |||
| Cardiology Technician | 246W00000X | |||
| Surgical Technologist | 246ZS0410X | |||
| Assistant Health Information Record Technician | 2470A2800X | |||
| Home Health Aide | 374U00000X | |||
| Nurse's Aide | 376K00000X | |||
| Personal Care Attendant | 3747P1801X | CNA 9994672 | PA | Primary |
Addresses
Primary practice location
714 Rhawn St
Apt 12a
Philadelphia, PA 19111-2513
Mailing address
714 Rhawn St
Apt 12a
Philadelphia, PA 19111-2513
Phone (215) 725-0648
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CNA 9994672 | PA | MD | Personal Care Attendant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719187200000",
"number": "1013166198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "714 RHAWN ST",
"address_2": "APT 12A",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191112513",
"telephone_number": "215-725-0648",
"fax_number": "267-467-0046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "714 RHAWN ST",
"address_2": "APT 12A",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191112513",
"telephone_number": "215-725-0648",
"fax_number": "267-467-0046"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANNON-PHILLIPS",
"first_name": "TANDALAYA",
"middle_name": "SARAH",
"name_prefix": "Ms.",
"credential": "SEERS LAMA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-15",
"last_updated": "2024-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "246R00000X",
"taxonomy_group": "",
"desc": "Technician, Pathology",
"state": null,
"license": null,
"primary": false
},
{
"code": "246W00000X",
"taxonomy_group": "",
"desc": "Technician, Cardiology",
"state": null,
"license": null,
"primary": false
},
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "2470A2800X",
"taxonomy_group": "",
"desc": "Technician, Health Information, Assistant Record Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": null,
"license": null,
"primary": false
},
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": null,
"license": null,
"primary": false
},
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": "PA",
"license": "CNA 9994672",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.