CHASE ANDREW CANNON PA
NPI 1053877902
Student in an Organized Health Care Education/Training Program in Nellis Afb, NV
About Chase Andrew Cannon Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CHASE ANDREW CANNON PA (NPI 1053877902) is an individual student in an organized health care education/training program in Nellis Afb, Nevada, licensed in Utah (12556320-8906) and active in the NPI registry since February 2019. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Chase Andrew Cannon Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
NELLIS AFB, NV 89191
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Chase Cannon's NPI number?
The NPI number for Chase Cannon is 1053877902. It was assigned to this individual provider in the NPPES registry on February 15, 2019.
Where is Chase Cannon located?
Chase Cannon practices at 4700 Las Vegas Blvd N, Nellis Afb, NV 89191. The listed phone number is (702) 653-2273.
What is Chase Cannon's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Chase Cannon enrolled in Medicare?
Yes. Chase Cannon is registered in the Medicare PECOS enrollment system.
What insurance does Chase Cannon accept?
Health plans from BridgeSpan Health Company, Providence Health Plan and Regence BlueCross BlueShield of Utah list Chase Cannon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Chase Cannon was last updated on August 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Chase Andrew Cannon, PA · NPI 1053877902
Student in an Organized Health Care Education/Training Program provider in Nellis Afb, Nevada. Individual provider, active in the CMS NPPES registry since February 15, 2019.
## Identity
- **NPI:** 1053877902 (Entity type: Individual)
- **Enumerated:** February 15, 2019
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **State license:** 12556320-8906 (Utah)
- **Sole proprietor:** No
## Practice location
- **Address:** 4700 LAS VEGAS BLVD N, Nellis Afb, NV 89191-6600
- **Phone:** (702) 653-2273
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** August 29, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1053877902) · Data from the CMS NPPES public registry.