Lacey Jo Cannon

Primary specialty

Home Health AideTaxonomy code 374U00000X

License

70974 Issued in WV

Practice address

1952 New Creek Hwy
Keyser, WV 26726-7494

Phone

(304) 597-1258

NPI assigned

Dec 19, 2022

Last updated

Dec 19, 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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1671408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1811609167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1952 NEW CREEK HWY",
            "city": "KEYSER",
            "state": "WV",
            "postal_code": "267267494",
            "telephone_number": "304-597-3522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1952 NEW CREEK HWY",
            "city": "KEYSER",
            "state": "WV",
            "postal_code": "267267494",
            "telephone_number": "304-597-1258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "LACEY",
        "middle_name": "JO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-19",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "WV",
            "license": "70974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70974",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lacey.cannon1@wvumedicine.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "1952 New Creek Hwy",
            "city": "Keyser",
            "state": "WV",
            "country_code": "US",
            "postal_code": "267267494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sharon Ann Butts
• Ali Cadili, MD
• Sydney Calain
• Tekena Alyee Callender
• Jennifer Lucian Cameron
• Caring Space, PLLC
• Vannessa Lynn Carter
• Lucas Matthew Case
• Shirley Casto
• Ryan Cavender, PHARMD

• Home Health Aide in Keyser, WV
• Providers in Keyser, WV by specialty
• Home Health Aide in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.