MS. TRICIA CANNON (PMHNP-BC) – Psychiatric/Mental Health Nurse Practitioner, NPI 1336996032

MS. TRICIA CANNON (PMHNP-BC) is a healthcare provider. based in Gray, Tennessee. specializing in NURSE PRACTITIONER. They hold the professional credentials PMHNP-BC. They hold a License No. 34720 (TN). The NPI Number for MS. TRICIA CANNON (PMHNP-BC) is 1336996032

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
MS. TRICIA CANNON (PMHNP-BC)
NPI
1336996032
Phone
(423) 467-3600
Address
1167 SPRATLIN PARK DR
Enumeration Date
1 May 2024
Last Update Date
27 June 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4234673600
Graduation Year
2023 (3 years ago)
PAC ID
2769928886
Group Practice PAC ID
2860302320
Professional Enrollment ID
I20240725001929
Address ID
TN376642523KI1570XRDXX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

10,664 NURSE PRACTITIONER in TN

Provider Addresses for MS. TRICIA CANNON (PMHNP-BC)

  • 1167 SPRATLIN PARK DR

    GRAY, TN 376156205

    Phone: (423) 467-3600

    Fax: (423) 467-3644

    Type: Mailing

  • 1570 WAVERLY RD

    KINGSPORT, TN 376642523

    Phone: (423) 224-1300

    Fax: (423) 224-1375

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 18 Open Payments records for all available years, with a total value of $439.

Total Amount is formed as General ($439) + Research ($0) + Ownership ($0) = $439.

Last reported payment date: 2024-12-11 • Largest payer in this snapshot: ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) ($119).

Total Amount

$439

General + Research + Ownership

Payments

18

Total payment records

General Amount

$439

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-11

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

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

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-07-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240725001929INurse PractitionerTNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 37615)

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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: 2860302320View full group profile

Reviews

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Frequently asked questions

What is the standard ID for MS. TRICIA CANNON (PMHNP-BC) in the U.S.?
In the U.S., MS. TRICIA CANNON (PMHNP-BC) is identified by NPI 1336996032.
Does the public listing show MS. TRICIA CANNON (PMHNP-BC) as active?
MS. TRICIA CANNON (PMHNP-BC)'s NPI record reflects an active status in NPPES.
How should patients interpret MS. TRICIA CANNON (PMHNP-BC)'s specialty?
The extract shows Psychiatric/Mental Health Nurse Practitioner for MS. TRICIA CANNON (PMHNP-BC). Clinical services aligned with this taxonomy classification.
What geographic area is tied to MS. TRICIA CANNON (PMHNP-BC)?
MS. TRICIA CANNON (PMHNP-BC) is associated with Gray, Tennessee in the same public data insurers reference.
Why is information missing for MS. TRICIA CANNON (PMHNP-BC)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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