Faith Forward Psychiatry LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

FAITH FORWARD PSYCHIATRY LLC

Practice address

7900 International Dr Ste 300-7007
Bloomington, MN 55425-1510

Phone

(715) 222-5958

NPI assigned

Feb 7, 2024

Organization subpart

No

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

Authorized official

Name

Ms. Cassie Renee Rider, PMHNP-BCNPI 1740955814

Title

Psychiatric Nurse Practitioner

Phone

(715) 222-5958

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cassie Renee Rider, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Little River, SC
  • NPI 1740955814

  MN

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1707264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707696000000",
    "number": "1083478374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1429 MAGEE CT",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295665927",
            "telephone_number": "715-222-5958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 INTERNATIONAL DR STE 300-7007",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251510",
            "telephone_number": "715-222-5958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITH FORWARD PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-07",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A",
        "authorized_official_last_name": "RIDER",
        "authorized_official_first_name": "CASSIE",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "PSYCHIATRIC NURSE PRACTITIONER",
        "authorized_official_telephone_number": "715-222-5958",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fairview Clinics
• Fairview Clinics
• Fairview Clinics
• Fairview Pharmacy Services LLC
• Fairview Pharmacy Services LLC
• Faith Path Care Inc
• Kaihan Fakhar
• Omowonuola Falae
• Emily Falch, MD
• Kelsey Kay Falzone, PA

• Psychiatric/Mental Health Nurse Practitioner in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.