NPIMap

Individual provider Active NPI

Kimmie L Cass, D.O.

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Belcamp, MD
National Provider Identifier
1013967454
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
2002-01349 Issued in NC
Practice address
1307 Cranesbill CT
Apt. 101
Belcamp, MD 21017-2415
Phone
(410) 652-4812
NPI assigned
May 10, 2006
Last updated
Mar 4, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 2002-01349 NC Primary

Addresses

Primary practice location

1307 Cranesbill CT
Apt. 101
Belcamp, MD 21017-2415

Mailing address

1307 Cranesbill CT
Apt. 101
Belcamp, MD 21017-2415
Phone (410) 652-4812

Other identifiers 3

IdentifierTypeStateIssuer
89-135YJMedicaidNC
135YJOtherNCBCBSNC
Q01349MedicaidSC

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
2002-01349NCMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Acute Care PA Pediatric Emergency Medicine Past Accepting new patients
Mid-Atlantic Emergency Medical Associates, PLLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kimmie.cass@pmuc.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1013967454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 CRANESBILL CT",
            "address_2": "APT. 101",
            "city": "BELCAMP",
            "state": "MD",
            "postal_code": "210172415",
            "telephone_number": "410-652-4812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 CRANESBILL CT",
            "address_2": "APT. 101",
            "city": "BELCAMP",
            "state": "MD",
            "postal_code": "210172415",
            "telephone_number": "410-652-4812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASS",
        "first_name": "KIMMIE",
        "middle_name": "L",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "NC",
            "license": "2002-01349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89-135YJ",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "135YJ",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q01349",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belcamp, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.

Verify at the official NPI Registry.