Cara Mae Canny

Key facts

NPI

1780147611

Entity type

Individual (NPI type 1)

Primary specialty

Speech-Language Pathologist 235Z00000X

Practice address

114 3Rd St SE
Fort Walton Beach, FL 32548-5401

Phone

(850) 243-6134

NPI assigned

Apr 8, 2019

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 8, 2019.

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554681600000",
    "number": "1780147611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 W NINE MILE RD UNIT 1207",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325345356",
            "telephone_number": "205-242-9891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 3RD ST SE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485401",
            "telephone_number": "850-243-6134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNY",
        "first_name": "CARA",
        "middle_name": "MAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-08",
        "last_updated": "2019-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Fort Walton Beach, FL · Speech-Language Pathologist in Florida