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KENDALL CANNON NP
NPI 1427702331
Nurse Practitioner - Psychiatric/Mental Health in Holloman Afb, NM

Active since February 09, 2022PECOS Enrolled
280 DAVID L GOLDFEIN ST BLDG 23, HOLLOMAN AFB, NM 88330(575) 572-2778 Get Directions Write a Review

NPPES record last updated: March 10, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Mar 10, 2025, Feb 10, 2022 (2 updates tracked since 2022).

About Kendall Cannon Np NPPES

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

KENDALL CANNON NP (NPI 1427702331) is an individual psychiatric/mental health provider in Holloman Afb, New Mexico, licensed in Maryland (R203938) and active in the NPI registry since February 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1427702331
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameKENDALL CANNONCredential: NP
Location Address280 DAVID L GOLDFEIN ST BLDG 23Holloman Afb, NM 88330-8273
Mailing Address3050 White Sands CtHolloman Air Force Base, NM 88330-8132 · (301) 268-3020
Phone(575) 572-2778
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateFebruary 9, 2022
Last NPPES UpdateMarch 10, 20252 updates tracked since enumeration
NPPES CertifiedMarch 10, 2025
✔ NPI 1427702331 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in MD · R203938
280 DAVID L GOLDFEIN ST BLDG 23, Holloman Afb, NM 88330
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

PECOS PAC ID6709342090
PECOS Enrollment IDI20260727004278
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.

Medicare Billing Reassignment

Medicare enrollment records show Kendall Cannon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Bright Horizons Psychiatry LLC
1,658 mi
Psychiatry
7360 GUILFORD DR STE 100
Frederick, MD 21704
  • Reassigned Medicare billing, District of Columbia and Maryland enrollments
  • 6 clinicians in this Medicare group
NPI 1922709146 (240) 599-1001

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 88330 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
$84.79 typical visit price
range $54.26 – $166.80
Typical copayment $21.19 (range $13.56 – $41.70)
Most-billed visit code 99203
Established Patient
$96.38 typical visit price
range $17.00 – $135.35
Typical copayment $24.09 (range $4.25 – $33.83)
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.

BRENNAN DREWRY
Counselor (Addiction (Substance Use Disorder))
280 DAVID L GOLDFEIN ST BLDG 23
HOLLOMAN AFB, NM 88330
Otero County (575) 572-5676
DR. JOHN FRANCIS SKICKI PSY.D.
Psychologist (Clinical)
280 DAVID L GOLDFEIN ST BLDG 23
HOLLOMAN AFB, NM 88330
Otero County (484) 709-0707
LAUREN HUDSON PA-S
Physician Assistant
280 DAVID L GOLDFEIN ST BLDG 23
HOLLOMAN AFB, NM 88330
Otero County (575) 572-0149
SHIRLEY DAKIN RD,CDE
Dietitian, Registered
280 DAVID L GOLDFEIN ST BLDG 23
HOLLOMAN AFB, NM 88330
Otero County (575) 572-5785
BRYAN THOMAS LANDRO MD
Pediatrics
280 DAVID L GOLDFEIN ST BLDG 23
HOLLOMAN AFB, NM 88330
Otero County (575) 572-7091
MRS. JAHNA MARIE PERRINE LCSW
Social Worker (Clinical)
280 DAVID L GOLDFEIN ST BLDG 23
HOLLOMAN AFB, NM 88330
Otero County (575) 572-7061
OSCAR OCHOA RAMOS LCSW
Social Worker
280 DAVID L GOLDFEIN ST BLDG 23
HOLLOMAN AFB, NM 88330
Otero County (575) 572-0461
MARY PATRIC LCSW
Social Worker (Clinical)
280 DAVID L GOLDFEIN ST BLDG 23
HOLLOMAN AFB, NM 88330
Otero County (575) 800-4205

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 Kendall Cannon's NPI number?

The NPI number for Kendall Cannon is 1427702331. It was assigned to this individual provider in the NPPES registry on February 9, 2022.

Where is Kendall Cannon located?

Kendall Cannon practices at 280 David L Goldfein St Bldg 23, Holloman Afb, NM 88330. The listed phone number is (575) 572-2778.

What is Kendall Cannon's specialty?

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

Is Kendall Cannon enrolled in Medicare?

Yes. Kendall Cannon is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kendall Cannon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kendall Cannon reassigns Medicare benefits to Bright Horizons Psychiatry LLC (Frederick, MD). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kendall Cannon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kendall Cannon was last updated on March 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.