DR. PHILLIP RANDAL JR. CANNON (DPT) – Physical Therapist, NPI 1265088439

DR. PHILLIP RANDAL JR. CANNON (DPT) is a healthcare provider. based in Honolulu, Hawaii. specializing in Physical Therapist. They hold the professional credentials DPT. They hold a License No. PT-4948 (HI). The NPI Number for DR. PHILLIP RANDAL JR. CANNON (DPT) is 1265088439

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
DR. PHILLIP RANDAL JR. CANNON (DPT)
NPI
1265088439
Phone
(808) 381-8947
Address
1401 S BERETANIA ST STE 550
Enumeration Date
14 August 2019
Last Update Date
30 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8083818947
Graduation Year
2019 (7 years ago)
PAC ID
7012247745
Group Practice PAC ID
5991132847
Professional Enrollment ID
I20200401002271
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

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Provider Addresses for DR. PHILLIP RANDAL JR. CANNON (DPT)

  • 550, South Beretania Street, Downtown, Hawaii Capital Historic District, Honolulu, Honolulu County, Hawaii, 96813, United States

    HONOLULU, HI 968141880

    Phone: (808) 381-8947

    Fax: (800) 586-4356

    Type: Mailing

  • 650 JOEL DR

    FORT CAMPBELL, KY 422235318

    Phone: (270) 461-5257

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97140Therapy procedure using manual technique, each 15 minutes3611$0
View full utilization report →

Insurance plans in this area (ZIP 96814)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5991132847View full group profile
NameSpecialtyState
-HI
-HI
Physical Therapist In Private PracticeHI
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeHI
Physical Therapist In Private PracticeHI
Physical Therapist In Private PracticeHI
Physical Therapist In Private PracticeHI

Reviews

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Frequently asked questions

Can I cross-check DR. PHILLIP RANDAL JR. CANNON (DPT) using NPI 1265088439?
NPI 1265088439 belongs to DR. PHILLIP RANDAL JR. CANNON (DPT); compare other details if you need extra assurance.
Active or inactive — what applies to DR. PHILLIP RANDAL JR. CANNON (DPT)?
You should see DR. PHILLIP RANDAL JR. CANNON (DPT) as active in CMS-hosted NPPES data.
What clinical focus is listed for DR. PHILLIP RANDAL JR. CANNON (DPT)?
At a glance, DR. PHILLIP RANDAL JR. CANNON (DPT) is tied to Physical Therapist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for DR. PHILLIP RANDAL JR. CANNON (DPT)?
Travel planning: use Honolulu, Hawaii as the reference point for DR. PHILLIP RANDAL JR. CANNON (DPT), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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