Melanie R Canna, OTR/L

Primary specialty

Neurorehabilitation Occupational TherapistTaxonomy code 225XN1300X

License

OT-1631 Issued in WY

Practice address

625 E Broadway Ave
Jackson, WY 83001-8642

Phone

(307) 733-3636

NPI assigned

Jun 10, 2022

Last updated

Jun 10, 2022By the provider in NPPES

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

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

{
    "created_epoch": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1972232288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4935 S 1750 E",
            "city": "VICTOR",
            "state": "ID",
            "postal_code": "834554304",
            "telephone_number": "585-733-0557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 E BROADWAY AVE",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018642",
            "telephone_number": "307-733-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNA",
        "first_name": "MELANIE",
        "middle_name": "R",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-10",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "WY",
            "license": "OT-1631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Neurorehabilitation Occupational Therapist in Jackson, WY
• Providers in Jackson, WY by specialty
• Neurorehabilitation Occupational Therapist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.