Mickie Lynn Cassidy, LSA, CSFA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

SA00649 Issued in TX

Practice address

1822 W Braker LN # 81603
Austin, TX 78758-3606

Phone

(512) 973-9222

NPI assigned

Jan 2, 2013

Last updated

May 2, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1357084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1033455530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 JASE DR",
            "city": "COPPERAS COVE",
            "state": "TX",
            "postal_code": "765224432",
            "telephone_number": "512-743-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1822 W BRAKER LN # 81603",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787583606",
            "telephone_number": "512-973-9222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Jase Dr",
            "address_purpose": "LOCATION",
            "city": "Copperas Cove",
            "state": "TX",
            "postal_code": "765224432",
            "country_code": "US",
            "telephone_number": "512-743-8787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASSIDY",
        "first_name": "MICKIE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LSA, CSFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-02",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "SA00649",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "SA00649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glory A Cassagnol, MA, LPC
• Cassandra Sorensen (Rumina Lactation)
• Susan Cassano, PH.D.
• Melody Cassels, MD
• Fiadh Aisling Cassidy
• Cassie Segerson Counseling, PLLC
• Jamie Lynne Cassity, M.D.
• Cristina Casstevens, PHD
• Jessica Winn Castagno, SLP MS SLP CCC
• Brittany Marie Castaneda, FNP-C, PMHNP-BC

• Surgery Physician in Austin, TX
• Providers in Austin, TX by specialty
• Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.

Verify at the official NPI Registry.