Active NPI
Kevin Charles Cannon, DPT
- Cardiopulmonary Physical Therapist
- Hampton, VA
National Provider Identifier
1538766720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiopulmonary Physical Therapist
- License
- 1572324
- Practice address
- 100 Emancipation Dr
Hampton, VA 23667-2254 - Phone
- (757) 722-9961
- NPI assigned
- Oct 1, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11285279-2401 | UT | |
| Cardiopulmonary Physical Therapist | 2251C2600X | 1572324 | WI | Primary |
Addresses
Primary practice location
100 Emancipation Dr
Hampton, VA 23667-2254
Mailing address
200 Smith Dr
Smithfield, VA 23430-1443
Phone (801) 360-5826
Other practice location 1
2500 Overlook Ter
Madison, WI 53705-2254
Phone (608) 256-1901 ext. 13133
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 |
|---|---|---|---|
| 11285279-2401 | UT | MD | Physical Therapist |
| 1572324 | WI | MD | Cardiopulmonary Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753228800000",
"number": "1538766720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 SMITH DR",
"city": "SMITHFIELD",
"state": "VA",
"postal_code": "234301443",
"telephone_number": "801-360-5826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 EMANCIPATION DR",
"city": "HAMPTON",
"state": "VA",
"postal_code": "236672254",
"telephone_number": "757-722-9961"
}
],
"practiceLocations": [
{
"address_1": "2500 Overlook Ter",
"address_purpose": "LOCATION",
"city": "Madison",
"state": "WI",
"postal_code": "537052254",
"country_code": "US",
"telephone_number": "608-256-1901 x13133",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CANNON",
"first_name": "KEVIN",
"middle_name": "CHARLES",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-01",
"last_updated": "2025-07-23",
"certification_date": "2025-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "UT",
"license": "11285279-2401",
"primary": false
},
{
"code": "2251C2600X",
"taxonomy_group": "",
"desc": "Physical Therapist, Cardiopulmonary",
"state": "WI",
"license": "1572324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hampton, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.