Cassie Jo Kelly, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN222812 Issued in GA

Practice address

1075 Lafayette Pkwy
Lagrange, GA 30241-3504

Phone

(706) 443-5273

NPI assigned

May 19, 2020

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 names 1

• Cassie Jo Sharman Former name

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": "1589846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1083237689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 PADDLE WHEEL DR",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302409122",
            "telephone_number": "706-302-3833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 LAFAYETTE PKWY",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302413504",
            "telephone_number": "706-443-5273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "CASSIE",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-19",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN222812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSIE",
            "last_name": "SHARMAN",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ravi Kumar Kamepalli, M.D.
• Tammi Kaminsky, D.C.
• Shih Yin Anna Kao, M.D.
• Manish C Kataria, RPH
• Ethel Mae Kelley
• Miriam Kelly, LPC
• Karen Armstrong Kennedy, DMD
• John Herbert Kent Jr., DC
• Douglas Brent Kersey Jr., DMD
• Meredith Key, ED.S., LPC, NCC

• Family Nurse Practitioner in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2020; 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.