Nathalia Kalena Cannon, MS

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

30003885 Issued in NC

Practice address

178 Mine Lake CT Ste 100
Raleigh, NC 27615-6417

Phone

(336) 430-8096

NPI assigned

Jan 22, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Expressable Speech-Language Pathology PCGroup PAC ID 4688074511, 115 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Expressable Speech-Language Pathology, P.C.

  • Speech-Language Pathologist
  • Austin, TX
  • NPI 1649875857

  NC

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1737504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1164234589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3403 SCENIC CLUB DR APT 3403",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275197811",
            "telephone_number": "828-838-9076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 MINE LAKE CT STE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276156417",
            "telephone_number": "336-430-8096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "NATHALIA",
        "middle_name": "KALENA",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-22",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30003885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Gail Cannon, BA IN PSYCHOLOGY
• Gregory J Cannon, MD
• Ja'Kyra Tannell Cannon, PTA
• Jacqueline Felicia Cannon, APRN, AGPCNP
• Katherine Clifton Cannon, RD
• Nihan Kaya Cannon, M.D.
• Shelia Cannon
• William Russell Cannon, M.D.
• Woodward Cannon, MD
• Alicia Cantrell

• Speech-Language Pathologist in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.