Individual provider Active NPI

Cassie J McKillip, FNP-C

  • Family Nurse Practitioner
  • Kokomo, IN
National Provider Identifier
1003659079
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71015652A Issued in IN
Practice address
2330 S Dixon Rd Ste 325
Kokomo, IN 46902-6430
Phone
(765) 455-8822
Fax
(765) 865-3935
NPI assigned
Jun 17, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28233872A IN
Family Nurse Practitioner 363LF0000X 71015652A IN Primary

Addresses

Primary practice location

2330 S Dixon Rd Ste 325
Kokomo, IN 46902-6430

Mailing address

6983 Hillsdale CT
Indianapolis, IN 46250-2054
Phone (317) 849-8350

Other identifiers 1

IdentifierTypeStateIssuer
300096968MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address referrals@jwmn.gwaydirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20240925003137 IN Practitioner - Nurse Practitioner 4385185768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Josephson-Wallack-Munshower Neurology PCGroup PAC ID 6709868870, 59 clinicians

Practice addresses (Care Compare)

2330 S Dixon Rd
Suite 325
Kokomo, IN 46902-6430
Phone (765) 455-8822

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71015652AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Josephson-Wallack-Munshower Neurology PC CurrentSince Sep 19, 2024 Accepting new patients
Josephson-Wallack-Munshower Neurology PC Past Accepting new patients
Joint Heirs Pediatrics LLC PastSince Jun 1, 2024 Accepting new patients

Locations

6983 Hillsdale Ct
Indianapolis, IN 46250

7250 Clearvista Dr
Ste 225
Indianapolis, IN 46256
Phone (317) 537-6088

1400 N Ritter Ave
Ste 220
Indianapolis, IN 46219
Phone (317) 355-1555

2330 S Dixon Rd
Ste 325
Kokomo, IN 46902
Phone (765) 455-8822

2330 S Dixon Rd
Kokomo, IN 46902
Phone (765) 455-5400

330 N Wabash Ave
Ste 470
Marion, IN 46952
Phone (765) 455-8822

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1753
  • Direct secure messaging: cmckillip@jwmn.gwaydirect.com
  • Direct secure messaging: referrals@jwmn.gwaydirect.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1003659079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6983 HILLSDALE CT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502054",
            "telephone_number": "317-849-8350",
            "fax_number": "317-849-8358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 S DIXON RD STE 325",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469026430",
            "telephone_number": "765-455-8822",
            "fax_number": "765-865-3935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKILLIP",
        "first_name": "CASSIE",
        "middle_name": "J",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-17",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28233872A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71015652A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300096968",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "referrals@jwmn.gwaydirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2330 S Dixon Rd",
            "city": "Kokomo",
            "state": "IN",
            "country_code": "US",
            "postal_code": "469026434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.