Kellen Cannon, in Edgewater, MD - Medicare Physical Therapist Provider

Kellen Cannon, is a medicare enrolled "Physical Therapist" provider in Edgewater, Maryland. Her current practice location is 9 Lee Airpark Dr Ste 400, Edgewater, Maryland. You can reach out to her office (for appointments etc.) via phone at (443) 607-1469.

Kellen Cannon is licensed to practice in Maryland (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1447920699.

Contact Information

	Kellen Cannon,
	9 Lee Airpark Dr Ste 400, Edgewater, MD 21037-1229
	(443) 607-1469
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Kellen Cannon
Gender	Female
Speciality	Physical Therapist
Location	9 Lee Airpark Dr Ste 400, Edgewater, Maryland
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1447920699
Provider Enumeration Date: 09/19/2021
Last Update Date: 09/22/2025

Medicare PECOS Information:

PECOS PAC ID: 8820486020
Enrollment ID: I20211020001554

Medical Identifiers

Medical identifiers for Kellen Cannon such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1447920699	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	(Maryland)	Primary
208100000X	Physical Medicine & Rehabilitation	2305214662 (Virginia)	Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kellen Cannon allows following entities to bill medicare on her behalf.

Provider Name	Nirschl Orthopaedic Center For Sportsmedicine & Joint Reconstruction
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1053459149 PECOS PAC ID: 8729065420 Enrollment ID: O20040701000074

Provider Name	Ati Holdings, Llc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1396781050 PECOS PAC ID: 9537112719 Enrollment ID: O20140610001109

Provider Name	Professional Sportscare & Rehab Llc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1033142294 PECOS PAC ID: 9335137363 Enrollment ID: O20160418000007

Provider Name	Virginia Luna Care Physical Therapy Llc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1235720848 PECOS PAC ID: 0941615405 Enrollment ID: O20210215000240

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kellen Cannon is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Kellen Cannon, 2001 Butterfield Rd Ste 1600, Downers Grove, IL 60515-1211 Ph: (866) 370-8206	Kellen Cannon, 9 Lee Airpark Dr Ste 400, Edgewater, MD 21037-1229 Ph: (443) 607-1469

Reviews and Comments

Physical Therapist in Edgewater, MD

Kevin Wrenn, D.P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3179 Braverton St, Suite 201, Edgewater, MD 21037 Phone: 410-956-4308
Bayside Physical Therpay And Sports Rehabilitation, Inc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3179 Braverton St, Suite 201, Edgewater, MD 21037 Phone: 410-956-4308
Dr. Alyssa Beskid Fenn, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 9 Lee Airpark Dr, Edgewater, MD 21037 Phone: 443-607-1469
Maureen K Walter, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 3179 Braverton St, Suite 201, Edgewater, MD 21037 Phone: 410-956-4308
Daniel Scott Hassell, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 9 Lee Airpark Dr Ste 400, Edgewater, MD 21037 Phone: 443-607-1469 Fax: 410-956-2618
Ms. Denise Arundell Swensen, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 140 Stepneys Ln, Edgewater, MD 21037 Phone: 410-956-3559
Britni Barber, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 9 Lee Airpark Dr Ste 400, Edgewater, MD 21037 Phone: 443-607-1469 Fax: 410-956-2618

Kellen Cannon, - Medicare Physical Therapist in Edgewater, MD