Active NPI
Hailey Lynn Cannan
- Physical Therapy Assistant
- St. Augustine, FL
National Provider Identifier
1821989955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 32688
- Practice address
- 4650 Sr-16
St. Augustine, FL 32092 - Phone
- (904) 940-2193
- NPI assigned
- Jul 15, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 32688 | FL | Primary |
Addresses
Primary practice location
4650 Sr-16
St. Augustine, FL 32092
Mailing address
4825 Avenue a
St Augustine, FL 32095-6267
Phone (239) 331-6899
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 |
|---|---|---|---|
| 32688 | FL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1752537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752537600000",
"number": "1821989955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4825 AVENUE A",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320956267",
"telephone_number": "239-331-6899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4650 SR-16",
"city": "ST. AUGUSTINE",
"state": "FL",
"postal_code": "32092",
"telephone_number": "904-940-2193"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANNAN",
"first_name": "HAILEY",
"middle_name": "LYNN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-07-15",
"last_updated": "2025-07-15",
"certification_date": "2025-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "32688",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St. Augustine, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.