Cassandra Dowker
Individual provider Active NPI Nurse Practitioner · Grand Ledge, MI
NPI 1043068091 · NPPES record last updated May 6, 2024
Key facts
- NPI
- 1043068091
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 4704308041 (MI)
- Practice address
- 6843 Mulberry LN
Grand Ledge, MI 48837-8750 - Phone
- (517) 455-5635
- NPI assigned
- May 6, 2024
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240920000335 | MI | Practitioner - Nurse Practitioner | 5698216406 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704308041 | MI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Recovery Physicians Network of Michigan | Current |
Accepting new patients | |
| Signify Health Medical Associates, PLLC | Nurse Practitioner | Current |
Accepting new patients |
| Havenwyck Hospital Inc | Past | Accepting new patients |
Locations
3645 E Jolly Rd
Ste A
Lansing, MI 48910
Phone (517) 939-9994
101 W Townsend Rd
Saint Johns, MI 48879
Phone (989) 403-6022
13 N Washington St
Ypsilanti, MI 48197
Phone (734) 329-4620
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704308041 | MI | Yes |
Addresses
Primary practice location
6843 Mulberry LN
Grand Ledge, MI 48837-8750
Mailing address
6843 Mulberry LN
Grand Ledge, MI 48837-8750
Phone (517) 455-5635
Other providers in Grand Ledge, MI
- Taylor Deacon
- Jami M Devarona
- Mary Elizabeth Dion
- Eleanor Dionise
- Divine Mind Consultation Services
- E & a Williams Corporation
- Nicole East
- Edward D. Ball D.O., P.C.
- Edward Troshak DDS, PC
- Edward W. Sparrow Hospital Association
All providers in Grand Ledge, MI · Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.