Active NPI
Damon Cannady, REGISTERED OPTICIAN
- Optician
- Colonial Heights, VA
National Provider Identifier
1174649446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 1101 002127
- Practice address
- 621 Southpark Blvd
Colonial Heights, VA 23834-3617 - Phone
- (804) 520-4687
- Fax
- (804) 520-4688
- NPI assigned
- Mar 21, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 1101 002127 | VA | Primary |
Addresses
Primary practice location
621 Southpark Blvd
Colonial Heights, VA 23834-3617
Mailing address
621 Southpark Blvd
Colonial Heights, VA 23834-3617
Phone (804) 520-4687
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 |
|---|---|---|---|
| 1101 002127 | VA | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174649446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "621 SOUTHPARK BLVD",
"city": "COLONIAL HEIGHTS",
"state": "VA",
"postal_code": "238343617",
"telephone_number": "804-520-4687",
"fax_number": "804-520-4688"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "621 SOUTHPARK BLVD",
"city": "COLONIAL HEIGHTS",
"state": "VA",
"postal_code": "238343617",
"telephone_number": "804-520-4687",
"fax_number": "804-520-4688"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANNADY",
"first_name": "DAMON",
"credential": "REGISTERED OPTICIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "VA",
"license": "1101 002127",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colonial Heights, VA
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- Cab King Inc (Boulevard Cab)
- Caldwell Pediatrics and Wellness Center PC
- David C Cangcuesta, MD
- Cardiology Associates of Central Virginia, PC
- Care Advantage, Inc.
- Care Diabetes and Endocrinology
- Careone
- Carlton E.Miller M.D.P.C (Arthritis and OsteoporosisClinic)
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.