Individual provider Active NPI

Cayla Paige Cannon, PT

  • Physical Therapist
  • Oak Ridge, TN
National Provider Identifier
1326551771
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11325 Issued in TN
Practice address
200 Bus Terminal Rd
Oak Ridge, TN 37830-6928
Phone
(865) 406-7129
Fax
(865) 951-7273
NPI assigned
Nov 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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 11325 TN Primary

Addresses

Primary practice location

200 Bus Terminal Rd
Oak Ridge, TN 37830-6928

Mailing address

3243 Heritage Cir
Hendersonville, NC 28791-3553
Phone (828) 713-0560

Other practice location 1

8024 Gleason Dr
Knoxville, TN 37919-5586
Phone (865) 406-7129

Other identifiers 1

IdentifierTypeStateIssuer
Q033325MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230515003201 TN Practitioner - Physical Therapist in Private Practice 9032575105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11325TNMDGeneral Practice Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Little Tennessee Valley Educational Cooperative Past Accepting new patients
Speech Pathology Services of East Tennessee LLC Physical Therapist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1510099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1326551771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3243 HERITAGE CIR",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287913553",
            "telephone_number": "828-713-0560",
            "fax_number": "865-951-7273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BUS TERMINAL RD",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306928",
            "telephone_number": "865-406-7129",
            "fax_number": "865-951-7273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8024 Gleason Dr",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379195586",
            "country_code": "US",
            "telephone_number": "865-406-7129",
            "fax_number": "865-951-7273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANNON",
        "first_name": "CAYLA",
        "middle_name": "PAIGE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-08",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "11325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q033325",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; 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.