Active NPI
Athena Brindle Cannon
- Ambulatory Care Pharmacist
- Minneapolis, MN
National Provider Identifier
1669091278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Pharmacist
- License
- 35171
- Practice address
- 1020 W Broadway Ave
Minneapolis, MN 55411-2504 - Phone
- (612) 302-8200
- NPI assigned
- Apr 14, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Care Pharmacist | 1835P2201X | 35171 | TX | Primary |
Addresses
Primary practice location
1020 W Broadway Ave
Minneapolis, MN 55411-2504
Mailing address
8521 Ashford Rd
Woodbury, MN 55125-8475
Phone (325) 200-7487
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 |
|---|---|---|---|
| 35171 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586822400000",
"number": "1669091278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8521 ASHFORD RD",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551258475",
"telephone_number": "325-200-7487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 W BROADWAY AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554112504",
"telephone_number": "612-302-8200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANNON",
"first_name": "ATHENA",
"middle_name": "BRINDLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-14",
"last_updated": "2020-04-14",
"certification_date": "2020-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "1835P2201X",
"taxonomy_group": "",
"desc": "Pharmacist, Ambulatory Care",
"state": "TX",
"license": "35171",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.