Individual provider Active NPI

Cassandra Tibbits

  • Social Worker
  • Wakefield, RI
National Provider Identifier
1013421858
Registry record updated Nov 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
100 Kenyon Ave
Wakefield, RI 02879-4216
Phone
(401) 782-8000
NPI assigned
Nov 30, 2017
Last updated
Nov 30, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

100 Kenyon Ave
Wakefield, RI 02879-4216

Mailing address

14 Woodruff Ave
Narragansett, RI 02882-3476
Phone (401) 595-0689

Other names 1

  • Cassandra Stukus Former name

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1512000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512000000000",
    "number": "1013421858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 WOODRUFF AVE",
            "city": "NARRAGANSETT",
            "state": "RI",
            "postal_code": "028823476",
            "telephone_number": "401-595-0689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 KENYON AVE",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028794216",
            "telephone_number": "401-782-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBBITS",
        "first_name": "CASSANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-30",
        "last_updated": "2017-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSANDRA",
            "last_name": "STUKUS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wakefield, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.