1. Home
  2. Directory
  3. Nevada
  4. Nellis Afb
  5. Physician Assistant
  6. NPI Profile

CHASE ANDREW CANNON PA
NPI 1053877902
Physician Assistant in Nellis Afb, NV

Active since February 15, 2019PECOS Enrolled
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191(702) 653-2273 Get Directions Write a Review

NPPES record last updated: September 29, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Sep 11, 2025, Apr 2, 2025, Dec 10, 2024 and 3 more (6 updates tracked since 2019).

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 physician assistant 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

NPI1053877902
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameCHASE ANDREW CANNONCredential: PA
Location Address4700 LAS VEGAS BLVD NNellis Afb, NV 89191-6600
Mailing Address4700 Las Vegas Blvd NNellis Afb, NV 89191-6600
Phone(702) 653-2273
Sole ProprietorNo
Enumeration DateFebruary 15, 2019
Last NPPES UpdateSeptember 29, 20256 updates tracked since enumeration
NPPES CertifiedSeptember 29, 2025
✔ NPI 1053877902 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in UT · 12556320-8906
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
4700 LAS VEGAS BLVD N, Nellis Afb, NV 89191
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Providence Health Plan, Regence BlueCross BlueShield of Utah.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).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 89191 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.51 typical visit price
range $57.07 – $173.24
Typical copayment $22.12 (range $14.26 – $43.31)
Most-billed visit code 99203
Established Patient
$71.14 typical visit price
range $18.27 – $140.96
Typical copayment $17.78 (range $4.56 – $35.24)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

DR. DEBRA A KOENIGSBERGER MD
Integrative Medicine
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-2267
KATRINA BAUMANN DPT
Physical Therapist (Orthopedic)
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-2273
SOUKAINA NOOR MD
Psychiatry & Neurology (Neurology)
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-2273
EDWARD KEMPTON MD
Emergency Medicine
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-2273
DR. AARON JOSEPH WOLBRUECK DO
Internal Medicine
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-2273
MARIA M ARAQUE PHARMD
Pharmacist
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-3202
DR. SHUBHANG N MAZUMDAR M.D.
Internal Medicine
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Clark County (702) 653-3800
CYNTHIA SCHMIDT PH.D.
Psychologist (Clinical)
4700 LAS VEGAS BLVD N, ATTN: CREDENTIALS OFFICE
NELLIS AFB, NV 89191
Clark County (702) 653-3067

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 Physician Assistant with taxonomy code 363A00000X.

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 September 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.