Active NPI
James Cannici, PHD
- Clinical Neuropsychologist
- Ft Worth, TX
National Provider Identifier
1265523484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 22101
- Practice address
- 909 W Magnolia Ave
Suite 20
Ft Worth, TX 76104-4571 - Phone
- (817) 925-6594
- Fax
- (888) 802-5455
- NPI assigned
- Sep 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 22101 | TX | Primary |
| Psychologist | 103T00000X | 22101 | TX |
Addresses
Primary practice location
909 W Magnolia Ave
Suite 20
Ft Worth, TX 76104-4571
Mailing address
909 W Magnolia Ave
Suite 20
Ft Worth, TX 76104-4571
Phone (817) 925-6594
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22101 | TX | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333670400000",
"number": "1265523484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "909 W MAGNOLIA AVE",
"address_2": "SUITE 20",
"city": "FT WORTH",
"state": "TX",
"postal_code": "761044571",
"telephone_number": "817-925-6594",
"fax_number": "888-802-5455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "909 W MAGNOLIA AVE",
"address_2": "SUITE 20",
"city": "FT WORTH",
"state": "TX",
"postal_code": "761044571",
"telephone_number": "817-925-6594",
"fax_number": "888-802-5455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANNICI",
"first_name": "JAMES",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-27",
"last_updated": "2012-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "TX",
"license": "22101",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "22101",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ft Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.