Michael Kollin Cannon, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT6701 Issued in MS

Practice address

5107 Beatline Rd Ste 300
Long Beach, MS 39560-3874

Phone

(228) 575-8429

Fax

(228) 575-8891

NPI assigned

Oct 19, 2020

Sex

Male

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

Enrolled in MS

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Encore Rehabilitation, IncGroup PAC ID 3577462126, 182 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Encore Rehabilitation, Inc.

  • Physical Therapy Clinic/Center
  • Decatur, AL
  • NPI 1033218524

  MS, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Encore Rehabilitation, Inc.

  • Occupational Medicine Clinic/Center
  • Gulfport, MS
  • NPI 1437962313

  Physical Therapist

  NPD

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1811596232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 JOHNSTON ST SE STE 200",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356012515",
            "telephone_number": "256-350-1764",
            "fax_number": "256-355-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5107 BEATLINE RD STE 300",
            "city": "LONG BEACH",
            "state": "MS",
            "postal_code": "395603874",
            "telephone_number": "228-575-8429",
            "fax_number": "228-575-8891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "MICHAEL",
        "middle_name": "KOLLIN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-19",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT6701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Hudson Boyer, PHARMD
• Emily Louise Bradford Sherwood, LPC
• Brittany Simmons Whole Health, LLC
• Julie E Brown, LPC
• Jennifer Kathryn Cameron, PHARM D
• Samuel Carr
• Megan Nicole Case, SLP
• Brenda Lee Chapman
• Nicole Clark, HAIR LOSS SPECIALIST
• Richard Clark

• Physical Therapist in Long Beach, MS
• Providers in Long Beach, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.