Cassandra Rae Hake

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160004911 Issued in IL

Practice address

6303 S Adams St
Bartonville, IL 61607-2517

Phone

(309) 363-6961

NPI assigned

Aug 1, 2011

Last updated

Aug 1, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312156800000",
    "number": "1053699546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6303 S ADAMS ST",
            "city": "BARTONVILLE",
            "state": "IL",
            "postal_code": "616072517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6303 S ADAMS ST",
            "city": "BARTONVILLE",
            "state": "IL",
            "postal_code": "616072517",
            "telephone_number": "309-363-6961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAKE",
        "first_name": "CASSANDRA",
        "middle_name": "RAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-01",
        "last_updated": "2011-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160004911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370686250001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lillian Marie Downing
• Dr. Jennifer R. Coverrdill, D.C.
• Patricia J Estep, CFNP
• Scott J Garvin, PHARMD
• Shanell Rena Gladson, APRN
• William C Hicok, M.D.
• Highland Park CVS, L.L.C. (CVS Pharmacy # 06446)
• James Horst, D.D.S.
• Joseph Frances Johnigk I, DC
• Vijaya Lakshmi Jujjavarapu, M.D.

• Physical Therapy Assistant in Bartonville, IL
• Providers in Bartonville, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2011; 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.