Active NPI
Bruce Alan Cassidy, M.D.
- Pulmonary Disease Physician
- Atlanta, GA
National Provider Identifier
1013919729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 17148
- Practice address
- 2001 Peachtree Rd NE
Suite 435
Atlanta, GA 30309-1476 - Phone
- (404) 352-1994
- Fax
- (404) 352-9361
- NPI assigned
- Aug 12, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 17148 | GA | Primary |
Addresses
Primary practice location
2001 Peachtree Rd NE
Suite 435
Atlanta, GA 30309-1476
Mailing address
PO Box 102847
Atlanta, GA 30368-0001
Phone (404) 352-1994
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00137563B | Medicaid | GA |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017148 | GA | MD | Pharmacist |
| 17148 | GA | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Piedmont Hospital, Inc | Past | Accepting new patients | |
| Piedmont Healthcare Inc | Past | Accepting new patients |
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.
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- Cardiovascular Disease Physician
- Stockbridge, GA
- NPI 1376624940
-
- General Acute Care Hospital
- Atlanta, GA
- NPI 1962461681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200009600000",
"number": "1013919729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 102847",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303680001",
"telephone_number": "404-352-1994",
"fax_number": "404-352-9361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 PEACHTREE RD NE",
"address_2": "SUITE 435",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303091476",
"telephone_number": "404-352-1994",
"fax_number": "404-352-9361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASSIDY",
"first_name": "BRUCE",
"middle_name": "ALAN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-12",
"last_updated": "2008-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "GA",
"license": "17148",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00137563B",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.