Individual provider Active NPI

Carrie Cannon

  • Psychiatric/Mental Health Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1063965077
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP8850 Issued in AZ
Practice address
50 E Croydon Park Rd
Tucson, AZ 85704-5792
Phone
(520) 696-3438
Fax
(520) 888-2347
NPI assigned
Jul 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X TAP8850 AZ
Family Nurse Practitioner 363LF0000X AP8850 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP8850 AZ Primary

Addresses

Primary practice location

50 E Croydon Park Rd
Tucson, AZ 85704-5792

Mailing address

6700 E Speedway, #123
1620 S Placita Churella, Tucson, Az 85748
Tucson, AZ 85710-0000
Phone (520) 820-9282

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20160920001790 AZ Practitioner - Nurse Practitioner 2062709934 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1620 S Placita Churella
Tucson, AZ 85748-7714
Phone (520) 800-9282

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as group
Quality
97.17
Promoting interoperability
99
Improvement activities
40
Cost
84.55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
TAP8850AZMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cannon Health Family CurrentSince Jun 7, 2025 Accepting new patients
Thrive Counseling LLC CurrentSince May 7, 2025 Accepting new patients
Dr. Gann'S Diet of Hope LLC CurrentSince Aug 8, 2016 Accepting new patients
Wellbeing Institute Inc Past Accepting new patients
Velo Med Urgent Care PC PastSince Aug 8, 2016 Accepting new patients
Wellbeing Institute Inc Past Accepting new patients

Locations

809 W Riordan Rd
Ste 202
Flagstaff, AZ 86001

4801 S Lakeshore Dr
Ste 207
Tempe, AZ 85282
Phone (623) 323-8962

333 E Wetmore Rd
Ste 137
Tucson, AZ 85705
Phone (602) 357-9986

6700 E Speedway Blvd
Tucson, AZ 85710
Phone (520) 448-9005

50 E Croydon Park Rd
Tucson, AZ 85704
Phone (520) 298-9887

2096 N Kolb Rd
Ste 107
Tucson, AZ 85715
Phone (520) 332-2494

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1063965077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 E SPEEDWAY, #123",
            "address_2": "1620 S PLACITA CHURELLA, TUCSON, AZ 85748",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857100000",
            "telephone_number": "520-820-9282",
            "fax_number": "866-403-5117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 E CROYDON PARK RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857045792",
            "telephone_number": "520-696-3438",
            "fax_number": "520-888-2347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "CARRIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-26",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "TAP8850",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP8850",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP8850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.