Angela D Cannon, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT0748 Issued in MS

Practice address

2210 Mill Street Ext # B
Lucedale, MS 39452-6064

Phone

(601) 947-9005

Fax

(601) 947-9007

NPI assigned

Apr 16, 2007

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 2

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.

• Encore Rehabilitation, Inc.

  • Physical Therapy Clinic/Center
  • Biloxi, MS
  • NPI 1720221195
  NPD (past)

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238457600000",
    "number": "1831314871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8419",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395358087",
            "telephone_number": "228-388-5714",
            "fax_number": "228-388-0017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 MILL STREET EXT # B",
            "city": "LUCEDALE",
            "state": "MS",
            "postal_code": "394526064",
            "telephone_number": "601-947-9005",
            "fax_number": "601-947-9007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "ANGELA",
        "middle_name": "D",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2009-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT0748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1033218524",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015077",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• George Patton Busby, R.PH.
• Ashlee Bush
• Deedy Hill Cain, NP-C
• Gay T Camagong, SLP
• Ashley E Campbell, PT
• Matthew Thomas Capalbo
• Jamarcus Keon Captville Sr.
• Lacey Elizabeth Carter, PMHNP
• Leigh Ann Cashwell, MD
• Marthajane S Cassidey, MS

• Physical Therapist in Lucedale, MS
• Providers in Lucedale, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2009; 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.