Shana Cole Cannon, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN0000078550 Issued in TN

Practice address

777 W. Poplar Ave.
Suite 104
Collierville, TN 38017

Phone

(901) 221-7175

Fax

(901) 221-7913

NPI assigned

Sep 17, 2013

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Premise Health of Tennessee Medical PC

  • Multi-Specialty Clinic/Center
  • Collierville, TN
  • NPI 1639742083
  NPD (past)

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1821424276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1992 HIGHWAY 51 S",
            "city": "COVINGTON",
            "state": "TN",
            "postal_code": "380193623",
            "telephone_number": "901-476-1820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 W. POPLAR AVE.",
            "address_2": "SUITE 104",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "38017",
            "telephone_number": "901-221-7175",
            "fax_number": "901-221-7913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "SHANA",
        "middle_name": "COLE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-17",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TN",
            "license": "LPN0000078550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa Call, PHARMD
• Nelson W. Campany, D.M.D.
• Campbell Clinic PC
• Jasmine Campbell
• Tammy L Camper, LSW
• Care of Angels Sitting Agency LLC
• Caremart Plus
• Latasha Carothers
• Jeffrey Thomas Carr, D.C.
• Rebekah Carr, CF-SLP

• Licensed Practical Nurse in Collierville, TN
• Providers in Collierville, TN by specialty
• Licensed Practical Nurse in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; 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.