Active NPI
Cassidy Elm
- Emergency Registered Nurse
- Meriden, CT
National Provider Identifier
1013418557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Registered Nurse
- License
- 185458
- Practice address
- 435 Lewis Ave
Meriden, CT 06451-2101 - Phone
- (203) 694-8200
- NPI assigned
- Feb 21, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Registered Nurse | 163WE0003X | 185458 | CT | Primary |
Addresses
Primary practice location
435 Lewis Ave
Meriden, CT 06451-2101
Mailing address
1376 Old Waterbury Rd
Southbury, CT 06488-1910
Phone (203) 264-8939
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 185458 | CT | MD | Emergency Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701993600000",
"number": "1013418557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1376 OLD WATERBURY RD",
"city": "SOUTHBURY",
"state": "CT",
"postal_code": "064881910",
"telephone_number": "203-264-8939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "435 LEWIS AVE",
"city": "MERIDEN",
"state": "CT",
"postal_code": "064512101",
"telephone_number": "203-694-8200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELM",
"first_name": "CASSIDY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-21",
"last_updated": "2023-12-08",
"certification_date": "2023-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "163WE0003X",
"taxonomy_group": "",
"desc": "Registered Nurse, Emergency",
"state": "CT",
"license": "185458",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Meriden, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.