Individual provider Active NPI

Jennifer Cannon, MPT

  • Physical Therapist
  • Littleton, CO
National Provider Identifier
1093822157
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
5920 S Estes St Ste 100
Littleton, CO 80123-8619
Phone
(303) 932-2500
Fax
(303) 932-2600
NPI assigned
Aug 24, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

5920 S Estes St Ste 100
Littleton, CO 80123-8619

Mailing address

8389 S Independence Cir Unit 306
Littleton, CO 80128-9256
Phone (720) 255-9659

Other identifiers 1

IdentifierTypeStateIssuer
7939OtherCOLICENSE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180418001478 OR Practitioner - Physical Therapist in Private Practice 7618068750 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Therapydia, Inc. Physical Therapist CurrentSince Sep 25, 2017 Accepting new patients
Therapydia, Inc. Physical Therapist CurrentSince Sep 25, 2017 Accepting new patients
Performax Front Range Physical Therapy LLC Physical Therapist Past Accepting new patients
Joseph J Teixeira RPT PC Physical Therapist PastSince May 1, 2002 Accepting new patients

Locations

18 E Blithedale Ave
Ste 21
Mill Valley, CA 94941

3925 SW 153rd Dr
Ste 210
Beaverton, OR 97003
Phone (503) 644-0600

2808 E Burnside St
Portland, OR 97214
Phone (503) 477-4802

Organizations & group practices 4

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093822157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8389 S INDEPENDENCE CIR UNIT 306",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801289256",
            "telephone_number": "720-255-9659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5920 S ESTES ST STE 100",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801238619",
            "telephone_number": "303-932-2500",
            "fax_number": "303-932-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "JENNIFER",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "7939",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Littleton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.