Shelby Christine Cannon, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT008551 Issued in GA

Practice address

536 Grand Slam Dr Ste D
Evans, GA 30809-8045

Phone

(706) 854-8434

NPI assigned

Jul 28, 2022

Last updated

Jul 28, 2022By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Therapy Trails of Evans

  • Multi-Specialty Clinic/Center
  • Evans, GA
  • NPI 1124677919
  NPD

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

{
    "created_epoch": "1658966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1376279745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 HAMPSTEAD PL",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309076202",
            "telephone_number": "706-339-2132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 GRAND SLAM DR STE D",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308098045",
            "telephone_number": "706-854-8434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "SHELBY",
        "middle_name": "CHRISTINE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-28",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT008551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Lenon Cain, MD
• Sanders R Callaway, MD
• Marjory Gean Campbell
• Christina Bell Canady, MCD, CCC SLP
• William Eugene Cannady, M.D.
• Caregiving and Aging Matters of Georgia, LLC
• Niti Bhalla Carlson, MD
• Chaltsy Carlton, D.O.
• Victoria Carnell, MS, OTR/L
• Gabrielle Carris

• Occupational Therapist in Evans, GA
• Providers in Evans, GA by specialty
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; 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.