NPIMap

Individual provider Active NPI

Helena Marie Cannon, MA, CCC-SLP

  • Speech-Language Pathologist
  • Wake Forest, NC
National Provider Identifier
1972037679
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
12313 Issued in NC
Practice address
432 Kings Glen Way
Wake Forest, NC 27587-3625
Phone
(919) 727-6907
NPI assigned
Apr 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 12313 NC Primary

Addresses

Primary practice location

432 Kings Glen Way
Wake Forest, NC 27587-3625

Mailing address

432 Kings Glen Way
Wake Forest, NC 27587-3625
Phone (919) 727-6907

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mcannon@stagestherapies.com Direct

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
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Stages Therapies Speech-Language Pathologist CurrentSince Nov 28, 2021 Accepting new patients
KM Pediatric Therapy, Inc. Speech-Language Pathologist Past Accepting new patients
Lolly Therapeutics, LLC Speech-Language Pathologist Past Accepting new patients
Therapeutic Specialties of North Carolina, PLLC Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1492560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1972037679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 KINGS GLEN WAY",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275873625",
            "telephone_number": "919-727-6907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 KINGS GLEN WAY",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275873625",
            "telephone_number": "919-727-6907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "HELENA",
        "middle_name": "MARIE",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-19",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "12313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcannon@stagestherapies.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "432 Kings Glen Way",
            "city": "Wake Forest",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275873625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wake Forest, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; 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.