Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Nicole Margaret Cannon, DPT

Individual provider Physical Therapist · NPI 1942451356

MS. Nicole Margaret Cannon, DPT is a Physical Therapist in Private Practice in Philadelphia, Pennsylvania. Qualified in 2008, 18 years ago. Practices with Ivyrehab Network Inc, a 653-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
18
Licensed in
PA
In the registry since
2008
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

2129 W Oregon Ave
Philadelphia, PA 19145-4131
Phone: (215) 336-6630
Fax: (215) 336-3928
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT019539 (PA)

Record details

NPI number1942451356
Entity typeIndividual (Type 1)
GenderFemale
Credentials DPT
Sole proprietorNo
NPI enumeratedOctober 3, 2008
Last updated in NPPESOctober 3, 2008

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Ivyrehab Network Inc — 653 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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