Individual provider Active NPI

Tandalaya Sarah Cannon-Phillips, SEERS LAMA

  • Personal Care Attendant
  • Philadelphia, PA
National Provider Identifier
1013166198
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
License
CNA 9994672 Issued in PA
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

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
CNA 9994672PAMDPersonal 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.

Verify at the official NPI Registry.