SHANNON CANNON
NPI 1417431263
Nurse Practitioner - Psychiatric/Mental Health in Media, PA

Q: What is Shannon Cannon's NPI number?

The NPI number for Shannon Cannon is 1417431263. It was assigned to this individual provider in the NPPES registry on September 18, 2018.

Q: What is Shannon Cannon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Shannon Cannon was last updated on January 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.

Active since September 18, 2018PECOS Enrolled

100 YEARSLEY MILL RD, MEDIA, PA 19063(888) 227-3898 Get Directions Write a Review

NPPES record last updated: January 22, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Shannon Cannon NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANNON CANNON (NPI 1417431263) is an individual psychiatric/mental health provider in Media, Pennsylvania, licensed in Pennsylvania (SPO30927) and active in the NPI registry since September 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1417431263

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameSHANNON CANNON

Location Address100 YEARSLEY MILL RDMedia, PA 19063-5593

Mailing Address812r Crum Creek RdSpringfield, PA 19064-1037

Phone(888) 227-3898

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateSeptember 18, 2018

Last NPPES UpdateJanuary 22, 2025

NPPES CertifiedJanuary 22, 2025

✔ NPI 1417431263 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in PA · SPO30927

Also ListedRegistered NurseTaxonomy 163W00000X · License RN627631 (PA)

100 YEARSLEY MILL RD, Media, PA 19063

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shannon Cannon is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5092217422

PECOS Enrollment IDI20250905001325

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 19063 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

$92.69 typical visit price

range $59.88 – $180.99

Typical copayment $23.17 (range $14.97 – $45.24)

Most-billed visit code 99203

Established Patient

$105.21 typical visit price

range $19.30 – $147.29

Typical copayment $26.30 (range $4.82 – $36.82)

Most-billed visit code 99214

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.

MARY ANN JACOBS

Registered Nurse (Addiction (Substance Use Disorder))