Individual provider Active NPI

Cassidy Thetford, AGNP-C

  • Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1013703966
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
38571 Issued in TN
Practice address
6019 Walnut Grove Rd
Memphis, TN 38120-2113
Phone
(901) 226-5000
NPI assigned
Apr 17, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 38571 TN Primary

Addresses

Primary practice location

6019 Walnut Grove Rd
Memphis, TN 38120-2113

Mailing address

965 Ridge Lake Blvd Ste 315
Memphis, TN 38120-9401
Phone (877) 348-1281

Other practice location 1

6019 Walnut Grove Rd Ste 210
Memphis, TN 38120-2113
Phone (901) 226-4910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20250701001131 TN Practitioner - Nurse Practitioner 7618480880 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

Practice addresses (Care Compare)

6019 Walnut Grove Rd
4 East
Memphis, TN 38120-2113
Phone (901) 226-0732

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Memorial Medical Group Inc CurrentSince Jul 1, 2025 Accepting new patients
Baptist Memorial Medical Group Inc Nurse Practitioner CurrentSince Jul 1, 2025 Accepting new patients

Locations

36 Capital Way
Ste E
Atoka, TN 38004
Phone (901) 837-6801

6019 Walnut Grove Rd
Ste 210
Memphis, TN 38120
Phone (901) 226-4910

6029 Walnut Grove Rd
Ste 210
Memphis, TN 38120
Phone (901) 226-2960

350 N Humphreys Blvd
Memphis, TN 38120
Phone (901) 226-4003

965 Ridge Lake Blvd
Ste 315
Memphis, TN 38120
Phone (877) 348-1281

6019 Walnut Grove Rd
#4E
Memphis, TN 38120
Phone (901) 226-0732

6019 Walnut Grove Rd
Memphis, TN 38120
Phone (901) 226-3190

Interoperability endpoints

  • Direct secure messaging: cboyd145839@direct.bmhcc.org

Organizations & group practices 2

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 1

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": "1744848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1013703966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 315",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209401",
            "telephone_number": "877-348-1281",
            "fax_number": "901-227-3206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6019 WALNUT GROVE RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202113",
            "telephone_number": "901-226-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6019 Walnut Grove Rd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381202113",
            "country_code": "US",
            "telephone_number": "901-226-4910",
            "fax_number": "901-226-4774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THETFORD",
        "first_name": "CASSIDY",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-17",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "38571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.