Courtney Leigh Cannon, BHRS

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

1407 SE Monroe St
Idabel, OK 74745-6619

Phone

(580) 612-8045

Fax

(580) 286-5185

NPI assigned

Jun 22, 2011

Last updated

Jun 22, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308700800000",
    "number": "1174819759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 SE MONROE ST",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747456619",
            "telephone_number": "580-612-8045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 SE MONROE ST",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747456619",
            "telephone_number": "580-612-8045",
            "fax_number": "580-286-5185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "COURTNEY",
        "middle_name": "LEIGH",
        "credential": "BHRS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-22",
        "last_updated": "2011-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janie Burris, RN
• Vanessa M Burris
• Kassandra Busse
• Gordon Butzirus, PA-C
• Jenna Leigh Buzan
• Tanaka Cantu, LPN
• Keeley Danielle Castillo, MS, RD, LD
• Claire Cavinder, PMHNP-BC
• Brenda Gayle Chadwick-Liechti, M.S.C., LPC, CM-A
• Chance Physical Therapy & Fitness PC

• Specialist in Idabel, OK
• Providers in Idabel, OK by specialty
• Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; 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.