Cassidy Sean Ford, PA-C

Individual provider Active NPI Physician Assistant · Black Mountain, NC

NPI 1053979955 · NPPES record last updated Nov 25, 2019

Key facts

NPI
1053979955
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
0010-09122 (NC)
Practice address
15 Jane Jacobs Rd
Black Mountain, NC 28711-6306
Phone
(828) 298-0333
NPI assigned
Jun 5, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20190821002558 NC Practitioner - Physician Assistant 0547598013

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Parkway Family Physicians PA Family Medicine Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-09122 NC Yes

Addresses

Primary practice location

15 Jane Jacobs Rd
Black Mountain, NC 28711-6306

Mailing address

PO Box 1869
Fletcher, NC 28732-1869
Phone (828) 687-5616

Other practice location 1

333 Gashes Creek Rd
Asheville, NC 28803-9405
Phone (828) 298-0333

Other providers in Black Mountain, NC

All providers in Black Mountain, NC · Physician Assistant in North Carolina

Sources for this page

Verify at the official NPI Registry.