Kaye B Cannon, OTRL CHT

Primary specialty

Hand Occupational TherapistTaxonomy code 225XH1200X

License

OTO912 Issued in MS

Practice address

1743 Cliff Gookin Blvd
Tupelo, MS 38801-6723

Phone

(662) 680-5216

Fax

(662) 680-5217

NPI assigned

May 3, 2006

Sex

Female

Sole proprietor

No

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.

• Drayer Physical Therapy Mississippi LLC

  • Physical Therapist
  • Crystal Springs, MS
  • NPI 1801333521
  NPD (past)
• Elite Physical Therapy

  • Occupational Therapist
  • Saltillo, MS
  • NPI 1871973636
  NPD (past)
• Specialty Orthopedic Group of Mississippi PLLC

  • Orthopaedic Surgery Physician
  • Tupelo, MS
  • NPI 1639553506
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 14, 2019.

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1972561470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1743 CLIFF GOOKIN BLVD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016723",
            "telephone_number": "662-680-5216",
            "fax_number": "662-680-5217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1743 CLIFF GOOKIN BLVD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016723",
            "telephone_number": "662-680-5216",
            "fax_number": "662-680-5217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "KAYE",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "OTRL CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "MS",
            "license": "OTO912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09788312",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Camellia Hospice of Northeast Mississippi, LLC
• Carrington Campbell
• Justin Campbell, NP
• Luke Jameson Campbell, M.D.
• Holly Williamson Cannon
• Susie Shantila Cannon, TRADITIONAL MIDWIFE
• John A Cantrell, M.D.
• Caitlyn Capps, M.S.,NCC,LPC/MHSP-T
• Cardinal Clinical Consulting, LLC
• Cardiology Associates of North Ms PA

• All providers in Tupelo, MS
• Hand Occupational Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2019; 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.