Kassidy Jo Treacey

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704352886 Issued in MI

Practice address

505 N Jackson St
Jackson, MI 49201-1266

Phone

(517) 748-5500

NPI assigned

Apr 21, 2025

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kthomsen947229@direct.hfhs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Center for Family Health

  • Federally Qualified Health Center (FQHC)
  • Jackson, MI
  • NPI 1780784439

  Family

  Medicare reassignment NPD
• Center for Family Health

  • Federally Qualified Health Center (FQHC)
  • Jackson, MI
  • NPI 1679905376
  NPD
• Center for Family Health

  • Federally Qualified Health Center (FQHC)
  • Jackson, MI
  • NPI 1710764410

  Family

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1745193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1003603481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N JACKSON ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011266",
            "telephone_number": "517-748-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N JACKSON ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011266",
            "telephone_number": "517-748-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREACEY",
        "first_name": "KASSIDY",
        "middle_name": "JO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-21",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704352886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tuwann Trammell
• Lauren Trancik, DDS
• Transcend Wellness Therapy, LLC
• Adam James Traud, CRNA
• Anthony Keith Travis, LLMSW
• Deanna Marie Tregoning, ARNP
• David Trevisan, MSOP, CO
• Trimas Family Care PLLC
• Eric T Trimas, DO
• Malcolm Trimble, MD

• Family Nurse Practitioner in Jackson, MI
• Providers in Jackson, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.